Jackie T. Chan, M.D., Inc.
NPI 1396954921 · Medical Specialty Clinic/Center · Modesto, CA
Jackie T. Chan, M.D., Inc. is a Medical Specialty Clinic/Center organization in Modesto, CA (NPI 1396954921).
Provider details
- NPI number
- 1396954921
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jackie Chan, President(209) 529-4422
- License
- G077865 (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-05-21
- Last updated
- 2023-08-24
- Certified
- 2023-08-24
Frequently asked questions
- What is Jackie T. Chan, M.D., Inc.'s NPI number?
- Jackie T. Chan, M.D., Inc.'s National Provider Identifier (NPI) is 1396954921, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackie T. Chan, M.D., Inc.?
- Jackie T. Chan, M.D., Inc. is classified in the NPPES registry as Medical Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is Jackie T. Chan, M.D., Inc. located?
- Jackie T. Chan, M.D., Inc.'s practice location on file with NPPES is 413 E Orangeburg Ave Ste a, Modesto, CA 95350-5369.
- What is Jackie T. Chan, M.D., Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Jackie T. Chan, M.D., Inc. is (209) 543-8880.
- Who is the authorized official for Jackie T. Chan, M.D., Inc.?
- The authorized official listed on Jackie T. Chan, M.D., Inc.'s NPPES record is Jackie Chan, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackie T. Chan, M.D., Inc.'s NPI active?
- Yes — Jackie T. Chan, M.D., Inc.'s NPI (1396954921) is active in the NPPES registry as of the last update on 2023-08-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.