Provider Demographics
NPI:1417961525
Name:MORGAN, CHADWICK J (MD)
Entity Type:Individual
Prefix:DR
First Name:CHADWICK
Middle Name:J
Last Name:MORGAN
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:PO BOX 3222
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0293
Mailing Address - Country:US
Mailing Address - Phone:707-261-7822
Mailing Address - Fax:707-256-3508
Practice Address - Street 1:199 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2954
Practice Address - Country:US
Practice Address - Phone:530-458-5821
Practice Address - Fax:530-458-3223
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA756442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I12522Medicare UPIN
00A756440Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID
CA00A756440Medicare PIN
CA00A756440Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID