MEDICARE: ESMOND KA-WAI CHAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	G38329	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083612626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESMOND KA-WAI CHAN M.D.

Provider Business Mailing Address
First Line	:	DEPT 9697
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90084-9697
Country	:	US
Telephone Number	:	949-721-6520
Fax Number	:	949-721-6120

Provider Business Practice Location Address
First Line	:	1069 LOS PALOS DR
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901
Country	:	US
Telephone Number	:	831-758-2724
Fax Number	:	831-758-1531

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/16/2007

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