Provider Demographics
NPI:1164687901
Name:JACQUES CHAHIN, M. D., INC.
Entity Type:Organization
Organization Name:JACQUES CHAHIN, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-689-4343
Mailing Address - Street 1:2700 GRANT ST.,
Mailing Address - Street 2:STE. 311
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-689-4343
Mailing Address - Fax:925-689-0114
Practice Address - Street 1:2700 GRANT ST STE 311
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2268
Practice Address - Country:US
Practice Address - Phone:925-689-4343
Practice Address - Fax:925-689-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-23509207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA235090Medicaid
CAOOA235090Medicare PIN
CAA23574Medicare UPIN