MEDICARE: CHACE SHAW, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1144154972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHACE SHAW, M.D., INC.

Provider Business Mailing Address
First Line	:	445 BURGESS DR STE 150
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-3475
Country	:	US
Telephone Number	:	650-427-0112
Fax Number	:	650-820-6775

Provider Business Practice Location Address
First Line	:	445 BURGESS DR STE 150
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-3475
Country	:	US
Telephone Number	:	650-427-0112
Fax Number	:	650-820-6775

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHACE SHAW
Credential	:	M.D.
Telephone Number	:	650-427-0112

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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