MEDICARE: CALVIN LUNG 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	63976	CA

General Provider Information

NPI Number	:	1639483324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALVIN LUNG CHAN PHARM. D.

Provider Business Mailing Address
First Line	:	400 EUCALYPTUS DR
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1529
Country	:	US
Telephone Number	:	415-794-2036
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 OCEAN AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1614
Country	:	US
Telephone Number	:	415-587-9000
Fax Number	:

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

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/05/2010

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