Provider Demographics
NPI:1659462687
Name:CAI, CHUNBO C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUNBO
Middle Name:C
Last Name:CAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 DIVISADERO ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3043
Mailing Address - Country:US
Mailing Address - Phone:415-833-3838
Mailing Address - Fax:415-833-2612
Practice Address - Street 1:1635 DIVISADERO ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3043
Practice Address - Country:US
Practice Address - Phone:415-833-3838
Practice Address - Fax:415-833-2612
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA206047208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0196461Medicaid
MAH63559Medicare UPIN
MAA34159Medicare ID - Type Unspecified