MEDICARE: JANET C CHAN, OD INC

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
1	152W00000X	Optometrist	11107T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740292655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANET C CHAN, OD INC

Provider Business Mailing Address
First Line	:	500 ALFRED NOBEL DR STE 138
Second Line	:
City	:	HERCULES
State	:	CA
Zip	:	94547-1839
Country	:	US
Telephone Number	:	510-724-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 ALFRED NOBEL DR
Second Line	:	STE 138
City	:	HERCULES
State	:	CA
Zip	:	94547-1838
Country	:	US
Telephone Number	:	510-724-1000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JANET CHAN
Credential	:	OD
Telephone Number	:	510-724-1000

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	05/14/2026

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