| Michelle L Chan A Professional Corporation | |
|
1726 New Ave San Gabriel CA 91776-3734 | |
| (626) 943-0780 | |
| (626) 943-0200 |
| Full Name | Michelle L Chan A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1726 New Ave, San Gabriel, California |
| Authorized Official Name and Position | Michelle L Chan (PRESIDENT) |
| Authorized Official Contact | 6269430780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle L Chan A Professional Corporation 1726 New Ave San Gabriel CA 91776-3734 Ph: (626) 943-0780 | Michelle L Chan A Professional Corporation 1726 New Ave San Gabriel CA 91776-3734 Ph: (626) 943-0780 |
| NPI Number | 1427361146 |
|---|---|
| Provider Enumeration Date | 07/22/2010 |
| Last Update Date | 09/14/2010 |
| Medicare PECOS PAC ID | 3274658786 |
|---|---|
| Medicare Enrollment ID | O20100921000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427361146 | NPI | - | NPPES |
| 00A547860 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A54786 (California) | Primary |
| Provider Name | Michelle L Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043326283 PECOS PAC ID: 7113042938 Enrollment ID: I20100917000070 |
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