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General NPI Number Information
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NPI Number | 1386722296
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Entity Type | Individual
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Provider Name | ALEXANDER Y CHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 4748 SAINT ANDREWS DRIVE
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City | STOCKTON
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State | CA
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Zip | 95219
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Country | US
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Telephone | 209-689-4607
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Fax | 888-250-8298
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Provider Business Mailing Address
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Address Line | P.O. BOX 7979
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City | STOCKTON
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State | CA
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Zip | 95267
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Country | US
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Telephone | 209-689-4607
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Fax | 888-250-8298
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A69498
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A69498
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License Number State | CA
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