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General NPI Number Information
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NPI Number | 1154624153
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Entity Type | Organization
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Legal Business Name | STEVE LI CHAN MD INC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 1106 S DIAMOND BAR BLVD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2203
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Country | US
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Telephone | 909-612-5835
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Fax | 909-612-5836
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Provider Business Mailing Address
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Address Line | 1106 S DIAMOND BAR BLVD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2203
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Country | US
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Telephone | 909-612-5835
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Fax | 909-612-5836
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Authorized Official
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Title or Position | MD
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Name | DR. STEVE L CHAN
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Credential | MD
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Telephone | 909-612-5835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A63015
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License Number State | CA
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