MEDICARE: DR. BENJAMIN Q CHAN MD

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	207Q00000X	Family Medicine Physician	2000157	NM
2	207Q00000X	Family Medicine Physician	16230	NV

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	16230	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1205920675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN Q CHAN MD

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	888-987-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 W CRAIG RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2737
Country	:	US
Telephone Number	:	725-269-3368
Fax Number	:	725-392-5350

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	06/06/2025

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