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General NPI Number Information
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NPI Number | 1700490257
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Entity Type | Individual
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Provider Name | MONICA M CHAN DPT, OCS
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 415-810-2732
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 TRIMMIER RD APT 15205
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City | KILLEEN
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State | TX
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Zip | 76542-6036
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT298888
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License Number State | CA
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