Individual provider Active NPI

Derrick CHI

  • Nurse Practitioner
  • San Gabriel, CA
National Provider Identifier
1750248233
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95039827 Issued in CA
Practice address
506 W Valley Blvd
San Gabriel, CA 91776-5716
Phone
(626) 308-3800
NPI assigned
Jan 7, 2026
Last updated
May 30, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 95039827 CA Primary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 95349463 CA

Addresses

Primary practice location

506 W Valley Blvd
San Gabriel, CA 91776-5716

Mailing address

12016 San Rio St
El Monte, CA 91732-1234
Phone (626) 532-3851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95349463CAMDRegistered Nurse
95039827CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1750248233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12016 SAN RIO ST",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917321234",
            "telephone_number": "626-532-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765716",
            "telephone_number": "626-308-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "DERRICK",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95039827",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95349463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.