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General NPI Number Information
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NPI Number | 1538255617
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Entity Type | Individual
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Provider Name | JOEL ANTEOL CHAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 756 LAKEFIELD RD SUITE C
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2673
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Country | US
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Telephone | 805-496-3838
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Fax | 419-866-8453
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Provider Business Mailing Address
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Address Line | 756 LAKEFIELD RD STE C
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2673
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Country | US
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Telephone | 805-496-3838
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Fax | 805-496-7418
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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 | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | A62548
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A62548
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License Number State | CA
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