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General NPI Number Information
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NPI Number | 1962351460
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Entity Type | Individual
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Provider Name | NITHI CHAN
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Gender | Male
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 20072 SW BIRCH ST STE 290
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0796
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Country | US
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Telephone | 949-379-8758
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Fax |
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Provider Business Mailing Address
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Address Line | 4486 S BRYANT PASEO
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City | ONTARIO
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State | CA
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Zip | 91762-7325
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95024826
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License Number State | CA
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