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General NPI Number Information
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NPI Number | 1972483360
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Entity Type | Individual
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Provider Name | KA MEI CHAN
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Gender | Female
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 11988 W FAIRVIEW AVE APT B109
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City | BOISE
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State | ID
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Zip | 83713-7826
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Country | US
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Telephone | 832-914-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 3499 E FAIRVIEW AVE
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City | MERIDIAN
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State | ID
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Zip | 83642-5848
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2771071
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License Number State | ID
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