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General NPI Number Information
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NPI Number | 1851407787
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Entity Type | Individual
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Provider Name | ROXANNE CHAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 06/14/2025
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Provider Practice Location Address
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Address Line | 2811 WILSHIRE BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90403-4803
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Country | US
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Telephone | 310-456-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 IRVINE AVE # 782
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-4602
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Country | US
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Telephone | 310-456-7828
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 152382
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A82201
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License Number State | CA
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