Organization Active NPI

Rick T Chac MD Inc

  • Obstetrics & Gynecology Physician
  • National City, CA
National Provider Identifier
1396134037
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
RICK T CHAC MD INC
Practice address
502 Euclid Ave
200
National City, CA 91950-2931
Phone
(619) 475-1261
Fax
(619) 475-1267
NPI assigned
Jan 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Mr. Rick T Chac, M.D.NPI 1538347760
Title
President
Phone
(619) 496-6266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

502 Euclid Ave
200
National City, CA 91950-2931

Mailing address

3774 Clairemont Dr
San Diego, CA 92117-5916
Phone (858) 274-1219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150312001288 CA Part B Supplier - Clinic/Group Practice 8921324815 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA; San Diego, CA

National Provider Directory

National Provider Directory

Locations

660 Old Telegraph Canyon Rd
Chula Vista, CA 91910
Phone (619) 482-2400

660 Old Telegraph Canyon Rd
#R
Chula Vista, CA 91910
Phone (619) 482-2400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1396134037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3774 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916",
            "telephone_number": "858-274-1219",
            "fax_number": "858-270-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE",
            "address_2": "200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502931",
            "telephone_number": "619-475-1261",
            "fax_number": "619-475-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICK T CHAC MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "CHAC",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-496-6266",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.