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General NPI Number Information
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NPI Number | 1700151958
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Entity Type | Individual
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Provider Name | MICHAEL PHILIP CHAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 2345 SPRUCE GOOSE ST # C234
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City | LAS VEGAS
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State | NV
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Zip | 89135-2625
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Country | US
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Telephone | 408-646-0984
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 SPRUCE GOOSE ST # C234
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City | LAS VEGAS
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State | NV
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Zip | 89135-2625
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Country | US
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Telephone | 408-646-0984
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Fax |
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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 | 01077874A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME131185
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 01077874A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | ME131185
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18478
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License Number State | NV
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