Active NPI
Gregory M. Chase, PA
- Physician Assistant
- Fontana, CA
National Provider Identifier
1174740658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14776
- Practice address
- 9961 Sierra Ave
Fontana, CA 92335-6720 - Phone
- (909) 427-3910
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA14776 | CA | Primary |
Addresses
Primary practice location
9961 Sierra Ave
Fontana, CA 92335-6720
Mailing address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-3910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA14776 | CA | MD | Physician Assistant |
| 14776 | CA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1174740658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-427-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-427-3910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASE",
"first_name": "GREGORY",
"middle_name": "M.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA14776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.