Healthcare Provider Details

I. General information

NPI: 1598269011
Provider Name (Legal Business Name): SZE MAN CHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 NORIEGA ST
SAN FRANCISCO CA
94122-4432
US

IV. Provider business mailing address

760 LAKEVIEW AVE
SAN FRANCISCO CA
94112-2258
US

V. Phone/Fax

Practice location:
  • Phone: 415-391-9686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95100793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: