Jackie Chan, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Pico Rivera, California. His current practice location is
8337 Telegraph Rd, Suite 206, Pico Rivera, California. You can reach out to his office (for appointments etc.) via phone at
(562) 806-1862.
Jackie Chan is licensed to practice in California (license number E2120) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417026881.
Healthcare Provider's Profile
Full Name | Jackie Chan |
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Gender | Male |
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Speciality | Podiatrist - Foot & Ankle Surgery |
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Location | 8337 Telegraph Rd, Pico Rivera, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417026881
- Provider Enumeration Date: 11/07/2006
- Last Update Date: 09/14/2012
Medicare PECOS Information:
- PECOS PAC ID: 0749496362
- Enrollment ID: I20110106000316
Medical Identifiers
Medical identifiers for Jackie Chan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417026881 | NPI | - | NPPES |
00021200 | Medicaid | CA | |
E2120 | Other | CA | CA MEDICAL LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
213ES0103X | Podiatrist - Foot & Ankle Surgery | E2120 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie Chan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jackie Chan, DPM 8337 Telegraph Rd, Suite 206, Pico Rivera, CA 90660-4909 Ph: (562) 806-1862 | Jackie Chan, DPM 8337 Telegraph Rd, Suite 206, Pico Rivera, CA 90660-4909 Ph: (562) 806-1862 |
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