Theodore John Chaconas, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G065093 Issued in CA

Practice address

747 52ND St
Oakland, CA 94609-1809

Phone

(510) 428-3237

Fax

(510) 601-3979

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ted John Chaconas Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013069806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3237",
            "fax_number": "510-601-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3237",
            "fax_number": "510-601-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACONAS",
        "first_name": "THEODORE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G065093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TED",
            "last_name": "CHACONAS",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angelica Inez Cervantez Ochoa
• Cesar Chavez Mtu (Alameda County CCS)
• Melissa Cesario, LMFT
• Sarah G Chaaito
• Alejandra Carolina Chacon Manriquez, RN, PMHNP
• Sindhu Chadalawada
• Dev Chahal, MD
• Harjit Kaur Chahal
• Harvind Chahal, MD
• Andrea Chai, MD

• Pediatrics Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.