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General NPI Number Information
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NPI Number | 1194750703
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Entity Type | Organization
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Legal Business Name | COMP DIABETES-ENDOCRINE MED ASSOC INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1660 SAN CARLOS AVE
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City | SAN CARLOS
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State | CA
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Zip | 94070-2022
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Country | US
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Telephone | 650-591-9933
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Fax | 650-591-9941
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Provider Business Mailing Address
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Address Line | 1660 SAN CARLOS AVE
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City | SAN CARLOS
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State | CA
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Zip | 94070-2022
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Country | US
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Telephone | 650-591-9933
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Fax | 650-591-9941
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Authorized Official
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Title or Position | MD/AO
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Name | LEILA CHAYCHI
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Credential | MD
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Telephone | 650-591-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A30023
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License Number State | CA
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