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General NPI Number Information
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NPI Number | 1023206216
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Entity Type | Individual
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Provider Name | JASON STEFAN CHAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 53 S PUUNENE AVE STE 108
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City | KAHULUI
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State | HI
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Zip | 96732-2192
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Country | US
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Telephone | 808-877-5657
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Fax | 808-877-5659
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Provider Business Mailing Address
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Address Line | PO BOX 700127
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City | KAPOLEI
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State | HI
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Zip | 96709-0127
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Country | US
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Telephone | 808-949-9585
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Fax | 808-748-3311
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | AMD-381
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1080343
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1080343
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1080343
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License Number State | FL
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