Provider Demographics
NPI:1194315564
Name:CHESS MEDICAL, P.C.
Entity type:Organization
Organization Name:CHESS MEDICAL, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-666-8145
Mailing Address - Street 1:99 HAWLEY LN STE 1102
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1204
Mailing Address - Country:US
Mailing Address - Phone:203-666-8145
Mailing Address - Fax:203-456-9793
Practice Address - Street 1:2642 CORTE VIDA
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5856
Practice Address - Country:US
Practice Address - Phone:203-666-8145
Practice Address - Fax:203-456-9793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty