Physician Compare National (NPI:1609818608)

HEALTHCARE PROVIDER: COOPER CHING CHAO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1609818608
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5193790822
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040826001435
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAO
	Individual professional last name
Provider First Name	COOPER
	Individual professional first name
Provider Middle Name	CHING
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9436056785
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	138
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	76 BROOKWOOD AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	SANTA ROSA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	954044312
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7075234907
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050131
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NOVATO COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050008
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CALIFORNIA PACIFIC MEDICAL CTR-DAVIES CAMPUS HOSP
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y