Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackie T. Chan, MD, Inc

Organization Medical Specialty Clinic/Center · NPI 1396954921

Jackie T. Chan, MD, Inc is a Medical Specialty Clinic/Center in Modesto, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

413 E Orangeburg Ave Ste A
Modesto, CA 95350-5369
Phone: (209) 543-8880
Fax: (209) 529-1711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence G077865 (CA)
Pain Clinic/Center Taxonomy 261QP3300X · Licence G077865 (CA)

Record details

NPI number1396954921
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jackie Chan — President · (209) 529-4422
NPI enumeratedMay 21, 2007
Last updated in NPPESAugust 24, 2023
Certification dateAugust 24, 2023
Mailing address4120 Dale Rd, Ste J8 #232, Modesto, CA 95356-9239

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