=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891062980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PC PROFESSIONAL CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2011
-----------------------------------------------------
Last Update Date | 11/17/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 835 JACKSON ST #403
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94133-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-940-1446
-----------------------------------------------------
Fax | 415-651-9252
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3053 FILLMORE ST #254
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94123-4009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-940-1446
-----------------------------------------------------
Fax | 415-651-9252
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | DR. PETER C CHEE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 415-940-1446
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | G57860
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------