Provider Demographics
NPI:1043306624
Name:CHAI, KASIN EKMAHA (MD)
Entity type:Individual
Prefix:DR
First Name:KASIN
Middle Name:EKMAHA
Last Name:CHAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1212 S BRISTOL ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-3476
Mailing Address - Country:US
Mailing Address - Phone:714-966-0646
Mailing Address - Fax:714-966-2438
Practice Address - Street 1:1212 S BRISTOL ST
Practice Address - Street 2:SUITE 16
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-3476
Practice Address - Country:US
Practice Address - Phone:714-966-0646
Practice Address - Fax:714-966-2438
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA36253208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A362530Medicaid
CAA28018Medicare UPIN
CA00A362530Medicaid