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NPI Code Detail

MEDICARE: PAMELA CHAN PHARM. D

MEDICARE: PAMELA 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
1183500000XPharmacist48969CA

General Provider Information

NPI Number : 1659685360
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA CHAN PHARM. D
Provider Business Mailing Address
First Line : 4044 EAGLE ROCK BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90065-3608
Country : US
Telephone Number : 323-254-8642
Fax Number :
Provider Business Practice Location Address
First Line : 4044 EAGLE ROCK BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90065-3608
Country : US
Telephone Number : 323-254-8642
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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Directions to “ PAMELA CHAN PHARM. D” Practice Location

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