MEDICARE: DR. JI YOUNG CHAE M.D. MPH

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	207R00000X	Internal Medicine Physician	A96193	CA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A96193	CA

General Provider Information

NPI Number	:	1912110537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JI YOUNG CHAE M.D. MPH

Provider Business Mailing Address
First Line	:	1450 TREAT BLVD STE 300
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-2168
Country	:	US
Telephone Number	:	925-952-2828
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 SAN PABLO AVE STE 310
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-2498
Country	:	US
Telephone Number	:	510-985-5020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	05/21/2025

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