Individual provider Active NPI

John P Chard, MD

  • Family Medicine Physician
  • San Clemente, CA
National Provider Identifier
1881706026
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C28147 Issued in CA
Practice address
665 Camino de Los Maes
#207
San Clemente, CA 92673
Phone
(949) 493-6113
Fax
(949) 493-5851
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C28147 CA Primary

Addresses

Primary practice location

665 Camino de Los Maes
#207
San Clemente, CA 92673

Mailing address

665 Camino de Los Maes
#207
San Clemente, CA 92673
Phone (949) 493-6113

Other identifiers 1

IdentifierTypeStateIssuer
C28147MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000010 CA Practitioner - Family Practice 3072669043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C28147CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
Mission City Community Network, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Monarch Healthcare, a Medical Group, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

3660 Wilshire Blvd
Ste 102
Los Angeles, CA 90010
Phone (213) 386-8866

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

15206 Parthenia St
Sepulveda, CA 91343

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881706026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MAES",
            "address_2": "#207",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-493-6113",
            "fax_number": "949-493-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MAES",
            "address_2": "#207",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-493-6113",
            "fax_number": "949-493-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARD",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C28147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C28147",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.