MEDICARE: MR. PING YING CHAN PHARM.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	183500000X	Pharmacist	RPH 48914	CA

General Provider Information

NPI Number	:	1245361864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PING YING CHAN PHARM.D.

Provider Business Mailing Address
First Line	:	4057 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-2536
Country	:	US
Telephone Number	:	323-264-7310
Fax Number	:

Provider Business Practice Location Address
First Line	:	4057 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-2536
Country	:	US
Telephone Number	:	323-264-7310
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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