Healthcare Provider Details

I. General information

NPI: 1255490744
Provider Name (Legal Business Name): RICHARD CHALKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 11/23/2023
Certification Date: 11/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 THOMPSON CT
MOUNTAIN VIEW CA
94043-2743
US

IV. Provider business mailing address

2329 THOMPSON CT
MOUNTAIN VIEW CA
94043-2743
US

V. Phone/Fax

Practice location:
  • Phone: 650-740-8777
  • Fax:
Mailing address:
  • Phone: 650-740-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG73720
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: