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General NPI Number Information
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NPI Number | 1639289614
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Entity Type | Individual
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Provider Name | FREDDY CHAN P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2063 S ATLANTIC BLVD SUITE 300
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6344
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Country | US
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Telephone | 323-796-0170
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Fax | 323-796-0220
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Provider Business Mailing Address
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Address Line | 5451 LA PALMA AVE SUITE 25
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City | LA PALMA
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State | CA
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Zip | 90623-1730
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Country | US
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Telephone | 714-670-1340
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Fax | 714-443-3780
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA17266
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17266
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA17266
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | PA17266
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | PA17266
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License Number State | CA
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