Healthcare Provider Details

I. General information

NPI: 1831849405
Provider Name (Legal Business Name): ANTHONY CHAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 BROOKSHIRE AVE OFC DOWNEY
DOWNEY CA
90241-4917
US

IV. Provider business mailing address

6240 RIDGEMONT DR
OAKLAND CA
94619-3725
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-5000
  • Fax:
Mailing address:
  • Phone: 510-282-7971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: