Jackie Chan, DPM is a
Podiatrist - Foot & Ankle Surgery based in Pico Rivera, California. Jackie Chan is licensed to practice in California (license number E2120) and his current practice location is
8337 Telegraph Rd, Suite 206, Pico Rivera, California. He can be reached at his office (for appointments etc.) via phone at
(562) 806-1862.
NPI number for Jackie Chan is 1417026881 and his current mailing address is 8337 Telegraph Rd, Suite 206, Pico Rivera, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417026881.
Healthcare Provider's Profile
Full Name | Jackie Chan |
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Gender | Male |
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Speciality | Podiatrist - Foot & Ankle Surgery |
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Location | 8337 Telegraph Rd, Pico Rivera, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417026881
- Provider Enumeration Date: 11/07/2006
- Last Update Date: 09/14/2012
Medical Identifiers
Medical identifiers for Jackie Chan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417026881 | NPI | - | NPPES |
00021200 | Medicaid | CA | |
E2120 | Other | CA | CA MEDICAL LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
213ES0103X | Podiatrist - Foot & Ankle Surgery | E2120 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie Chan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jackie Chan, DPM 8337 Telegraph Rd, Suite 206, Pico Rivera, CA 90660-4909 Ph: (562) 806-1862 | Jackie Chan, DPM 8337 Telegraph Rd, Suite 206, Pico Rivera, CA 90660-4909 Ph: (562) 806-1862 |
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