Provider Demographics
NPI:1215036066
Name:CHEW, CLIFFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:
Last Name:CHEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 CLAY ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108
Mailing Address - Country:US
Mailing Address - Phone:415-433-7945
Mailing Address - Fax:415-433-1231
Practice Address - Street 1:929 CLAY ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-433-7945
Practice Address - Fax:415-433-1231
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA624720207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9864433Medicaid
00A624720Medicare ID - Type Unspecified
H16229Medicare UPIN
CA9864433Medicaid