Provider Demographics
NPI:1598777492
Name:RICHARD CHAI M.D., MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RICHARD CHAI M.D., MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-483-7757
Mailing Address - Street 1:375 W CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3042
Mailing Address - Country:US
Mailing Address - Phone:714-482-2121
Mailing Address - Fax:
Practice Address - Street 1:375 W CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3042
Practice Address - Country:US
Practice Address - Phone:714-482-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty