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NPI Code Detail

MEDICARE: DR. CHRISTOPHER CHAN PHARM.D.

MEDICARE: DR. CHRISTOPHER CHAN PHARM.D.
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
1183500000XPharmacist62041CA

General Provider Information

NPI Number : 1063713048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER CHAN PHARM.D.
Provider Business Mailing Address
First Line : 815 CANYON DEL REY BLVD
Second Line :
City : DEL REY OAKS
State : CA
Zip : 93940-5525
Country : US
Telephone Number : 831-393-2104
Fax Number : 831-393-2109
Provider Business Practice Location Address
First Line : 815 CANYON DEL REY BLVD
Second Line :
City : DEL REY OAKS
State : CA
Zip : 93940-5525
Country : US
Telephone Number : 831-393-2104
Fax Number : 831-393-2109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2010
Last Update Date : 11/08/2010

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