| Michael Chai Md Inc | |
|
1113 Alta Av # 106 Upland CA 91786 | |
| (909) 920-6672 | |
| (909) 931-7192 |
| Full Name | Michael Chai Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1113 Alta Av, Upland, California |
| Authorized Official Name and Position | Michael Chai (CEO) |
| Authorized Official Contact | 9099206672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Chai Md Inc 1113 Alta Av # 106 Upland CA 91786 Ph: (909) 920-6672 | Michael Chai Md Inc 1113 Alta Av # 106 Upland CA 91786 Ph: (909) 920-6672 |
| NPI Number | 1568572949 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0840382818 |
|---|---|
| Medicare Enrollment ID | O20070822000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568572949 | NPI | - | NPPES |
| 00G799650 | Other | MEDICAL DR CHAI | |
| 00A780920 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G079965 (California) | Primary |
| 207R00000X | Internal Medicine | A78092 (California) | Secondary |
| Provider Name | Michael Chai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083748727 PECOS PAC ID: 2365540408 Enrollment ID: I20070613000243 |
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