Basic Information
| Provider Information | |||||||||
| NPI: | 1417102633 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHASE | ||||||||
| FirstName: | JORDAN | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 995 POTRERO AVE # WARD83 | ||||||||
| Address2: | SFGH DEPT OF FAMILY AND COMMUNITY MEDICINE | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941102859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152065252 | ||||||||
| FaxNumber: | 4152068387 | ||||||||
| Practice Location | |||||||||
| Address1: | 995 POTRERO AVE # WARD83 | ||||||||
| Address2: | SFGH DEPT OF FAMILY AND COMMUNITY MEDICINE | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941102859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152065252 | ||||||||
| FaxNumber: | 4152068387 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2008 | ||||||||
| LastUpdateDate: | 12/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A106092 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.