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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKIE T. CHAN, M.D., INC.

Active Organization

JACKIE T. CHAN, M.D., INC. is a Medical Specialty Clinic organization located in MODESTO, California. NPI 1396954921 is currently active in the NPPES registry. Verify at CMS.

Medical Specialty Clinic · MODESTO, CA

Registration Details

NPI Number
1396954921
Provider Type
Organization
NPI Issued
May 21, 2007 (19.277034683473 yrs)
Last Updated
Aug 24, 2023
Licenses
G077865 (CA)
G077865 (CA)

Practice Information

Address
413 E ORANGEBURG AVE STE A
MODESTO, CA, 953505369
Browse CA providers · Browse ZIP 95350
Phone
2095438880
Fax
2095291711
Primary Specialty
Medical Specialty Clinic
261QM2500X
Additional Specialty
Medical Specialty Clinic

Other Medical Specialty Clinic Organizations in MODESTO, CA

Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.