Jacqueline S Chan DO A Medical Corporation
Clinic/Center in San Rafael, CA. Organization (NPI-2).
NPI number1194352930
StatusActive
Last updated in NPPESFeb 4, 2026
Details
- NPI
- 1194352930
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacqueline S Chan DO A Medical Corporation
- Organization subpart
- No
- Enumeration date
- Mar 23, 2020
- Certification date
- Feb 4, 2026
- Last updated
- Feb 4, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 2083P0011X | Preventive Medicine, Undersea and Hyperbaric Medicine | – | – |
Other names
- Hyperbaric Oxygen Therapy (Doing Business As)
Practice location
1118 Irwin StSan Rafael, CA 94901-3322
Phone 415-785-8652
Mailing address
1118 Irwin StSan Rafael, CA 94901-3322
Authorized official
Jacqueline Chan
DO / Owner
4157858652
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