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General NPI Number Information
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NPI Number | 1366468332
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Entity Type | Individual
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Provider Name | DANIEL S. CHAN PHD, FICPP
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 3733 ROSEMEAD BLVD SUITE 201
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City | ROSEMEAD
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State | CA
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Zip | 91770-1981
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Country | US
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Telephone | 818-229-6121
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Fax | 818-352-6262
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Provider Business Mailing Address
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Address Line | 11107 MCVINE AVE
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City | SUNLAND
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State | CA
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Zip | 91040-2121
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Country | US
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Telephone | 818-229-6121
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Fax | 818-352-6262
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY11140
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License Number State | CA
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