Jacqueline S Chan DO a Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

JACQUELINE S CHAN DO A MEDICAL CORPORATION

Practice address

1118 Irwin St
San Rafael, CA 94901-3322

Phone

(415) 785-8652

NPI assigned

Mar 23, 2020

Organization subpart

No

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

Authorized official

Name

Jacqueline Chan, DONPI 1740267715

Title

DO / Owner

Phone

(415) 785-8652

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Hyperbaric Oxygen Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Susanna Chan, D.O./OSTEOPATH

  • Family Medicine Physician
  • Larkspur, CA
  • NPI 1740267715
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1194352930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 IRWIN ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 IRWIN ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013322",
            "telephone_number": "415-785-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE S CHAN DO A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DO / OWNER",
        "authorized_official_telephone_number": "415-785-8652",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "10041",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hyperbaric Oxygen Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hyperbaric Oxygen Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Jackson
• Talita Calazans Jackson, MA, LMFT
• Larry Alan Jacobs, MFT
• Jessica Jacobson, MSW
• Jacqueline Kotula, DDS, Inc.
• Ruth Jaeger, LCSW
• James D Taylor MD Inc
• Meghan L James
• Hyunae Jang, D.M.D
• Miriam Jang, MD

• Clinic/Center in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.