Individual
DR. CLARA CHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
4646 BROCKTON AVE STE 201, RIVERSIDE, CA 92506-0104
(951) 585-1800
(951) 585-1801
Mailing address
6250 CLAY ST, RIVERSIDE, CA 92509-6005
(951) 360-5265
(951) 360-6276
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35095607
OH
207VX0000X
Obstetrics Physician
Primary
128817
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639274319
SITE PTAN
CA
05
—
3103368
—
OH
01
—
4304441
MEDICARE ID
OH
01
—
ZZZ31887Z
GROUP PTAN
CA
Enumeration date
06/15/2007
Last updated
02/10/2022
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