Provider Demographics
NPI:1700988003
Name:CHECA, JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:CHECA
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 1:2360 PASEO DE CIMA
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1037
Mailing Address - Country:US
Mailing Address - Phone:818-445-8870
Mailing Address - Fax:
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2500
Practice Address - Country:US
Practice Address - Phone:818-243-6285
Practice Address - Fax:818-243-5835
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31702207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A317020Medicaid
CAA31702Medicare UPIN
CA00A317020Medicaid