Provider Demographics
NPI:1447600309
Name:CHAO, CELIA DIFAN (DO)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:DIFAN
Last Name:CHAO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 LAS TABLAS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9759
Mailing Address - Country:US
Mailing Address - Phone:805-434-2533
Mailing Address - Fax:
Practice Address - Street 1:153 CAYUGA ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2626
Practice Address - Country:US
Practice Address - Phone:831-296-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC218638390200000X
CA20A16425207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program