Basic Information
| Provider Information | |||||||||
| NPI: | 1487757779 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHASE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 45680 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941450680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303442000 | ||||||||
| FaxNumber: | 5303442014 | ||||||||
| Practice Location | |||||||||
| Address1: | 4300 GOLDEN CENTER DR | ||||||||
| Address2: | SUITE D | ||||||||
| City: | PLACERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956676278 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303442000 | ||||||||
| FaxNumber: | 5303442014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2006 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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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 | 207K00000X | G74828 | CA | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | 207Y00000X | G74828 | CA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.