Healthcare Provider Details

I. General information

NPI: 1932859675
Provider Name (Legal Business Name): PEARL CHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 E VALPICO RD
TRACY CA
95376-9100
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 209-830-4072
  • Fax: 209-452-3191
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA204116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: