Provider Demographics
NPI:1588761951
Name:CHAHIN, JACQUES (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUES
Middle Name:
Last Name:CHAHIN
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 1:2700 GRANT ST
Mailing Address - Street 2:STE 311
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2268
Mailing Address - Country:US
Mailing Address - Phone:925-689-4343
Mailing Address - Fax:925-689-0114
Practice Address - Street 1:2700 GRANT ST
Practice Address - Street 2:STE 311
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2268
Practice Address - Country:US
Practice Address - Phone:925-689-4343
Practice Address - Fax:925-689-0114
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23509207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A235090Medicaid
CA00A235090Medicaid
A23574Medicare UPIN