Physician Compare National (NPI:1003841834)

HEALTHCARE PROVIDER: MICHAEL WAYNE CHAN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003841834
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527247188
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110127001125
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAN
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	WAYNE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	98 -1079 MOANALUA RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 655
	Group Practice or individual's line 2 address
City	AIEA
	Group Practice or individual's city
State	HI
	Group Practice or individual's state
Zip Code	967014724
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	120026
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PALI MOMI MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y