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Jackie T. Chan, M.d., Inc.
Pain Clinic/Center in Modesto, California
NPI 1396954921

Jackie T. Chan, M.d., Inc. is a Pain Clinic/Center based in Modesto, CA and is specialized in Pain. Jackie T. Chan, M.d., Inc. practices in Modesto, CA. The NPI Number for Jackie T. Chan, M.d., Inc. is 1396954921 and holds a License No. G077865 (California).

The current practice location address for Jackie T. Chan, M.d., Inc. is 413 E Orangeburg Ave Ste A, Modesto, CA and can be reached out via phone at 209-543-8880 and via fax at 209-529-1711. You can also correspond with Jackie T. Chan, M.d., Inc. through the mailing address at 4120 DALE RD, MODESTO, CA - 95356-9239 (mailing address contact number: 209-529-4422).

Location: 413 E Orangeburg Ave Ste A, Modesto, CA, 95356-9239
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1396954921
Provider Name
Jackie T. Chan, M.d., Inc.
Credential
Provider Entity Type
Organization
Address
413 E Orangeburg Ave Ste A, Modesto, CA, 95356-9239
Phone Number
209-543-8880
Fax Number
209-529-1711
Provider Enumeration Date
05/21/2007
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
413 E Orangeburg Ave Ste A
City
Modesto
State
California
Zip
95350-5369
Phone Number
209-543-8880
Fax Number
209-529-1711
person
Provider Business Mailing Address Details
Address
413 E Orangeburg Ave Ste A
City
Modesto
State
California
Zip
95350-5369
Phone Number
209-543-8880
Fax Number
209-529-1711
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
G077865 (California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Pain
Taxonomy
261QP3300X
License No.
G077865 (California)
Definition
Definition to come...
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