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General NPI Number Information
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NPI Number | 1629778733
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Entity Type | Organization
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Legal Business Name | ALBERT D CHAN MD INC
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2150 COLORADO AVE
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City | TURLOCK
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State | CA
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Zip | 95382-2003
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Country | US
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Telephone | 415-819-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 10262 GILLIAM DR
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City | ELK GROVE
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State | CA
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Zip | 95757-3551
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Country | US
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Telephone | 415-819-4103
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. ALBERT D CHAN
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Credential | MD
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Telephone | 415-819-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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