Organization Active NPI

Jon W Churnin MD Inc

  • Pain Medicine (Anesthesiology) Physician
  • Daly City, CA
National Provider Identifier
1619011095
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
G34291 Issued in CA
Legal business name
JON W CHURNIN MD INC
Practice address
901 Campus Dr Ste 102
Daly City, CA 94015-4930
Phone
(650) 991-2000
NPI assigned
Feb 18, 2007
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Dr. Jon W Churnin, MDNPI 1841283892
Title
Owner
Phone
(650) 343-9746

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X G34291 CA Primary

Addresses

Primary practice location

901 Campus Dr Ste 102
Daly City, CA 94015-4930

Mailing address

219 Elm St Apt 5
San Mateo, CA 94401-2640
Phone (650) 343-9746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081118000400 CA Part B Supplier - Clinic/Group Practice 9032279229 Receives reassigned benefits from 1 practitioner
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1619011095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 ELM ST APT 5",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012640",
            "telephone_number": "650-343-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR STE 102",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154930",
            "telephone_number": "650-991-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON W CHURNIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-18",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "CHURNIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-343-9746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G34291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.