Provider Demographics
NPI:1639146442
Name:ZAHN, CHESTER D (MD)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:D
Last Name:ZAHN
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 1:1026 E LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1633
Mailing Address - Country:US
Mailing Address - Phone:626-287-7222
Mailing Address - Fax:626-287-1991
Practice Address - Street 1:1026 E LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1633
Practice Address - Country:US
Practice Address - Phone:626-287-7222
Practice Address - Fax:626-287-1991
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69510207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG69510OtherCA MEDICAL BOARD
CA00G695100Medicaid
CAF14826Medicare UPIN
CA00G695100Medicaid