Individual provider Active NPI

Chonghao Zhao, M.D., PHD, DABMA

  • Specialist
  • San Gabriel, CA
National Provider Identifier
1902930019
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A66257 Issued in CA
Practice address
420 W Las Tunas Dr
San Gabriel, CA 91776-1268
Phone
(626) 457-1688
Fax
(626) 457-1638
NPI assigned
Mar 14, 2007
Last updated
Oct 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A66257 CA Primary

Addresses

Primary practice location

420 W Las Tunas Dr
San Gabriel, CA 91776-1268

Mailing address

420 W Las Tunas Dr
San Gabriel, CA 91776-1268
Phone (626) 457-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050516000327 CA Practitioner - NeurologyPractitioner - Interventional Pain Management 3779524293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Interventional Pain Management
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 W Las Tunas Dr
San Gabriel, CA 91776-1268
Phone (626) 457-1688

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
California Headache and Pain Specialist, Inc. CurrentSince Mar 1, 2005 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Western Pain and Headache Center, Inc. Specialist PastSince Nov 1, 2006 Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

420 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 296-9500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1902930019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761268",
            "telephone_number": "626-457-1688",
            "fax_number": "626-457-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761268",
            "telephone_number": "626-457-1688",
            "fax_number": "626-457-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "CHONGHAO",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD, DABMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A66257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.