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NPI Code Detail

MEDICARE: DR. KIAT YEONG CHAN M.D.

MEDICARE: DR. KIAT YEONG 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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianA91315CA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianME 95070FL

General Provider Information

NPI Number : 1871776609
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIAT YEONG CHAN M.D.
Provider Business Mailing Address
First Line : 17228 VAN NESS AVE
Second Line :
City : TORRANCE
State : CA
Zip : 90504-2933
Country : US
Telephone Number : 310-516-6340
Fax Number : 310-516-6340
Provider Business Practice Location Address
First Line : 2440 S SEPULVEDA BLVD STE 110
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1744
Country : US
Telephone Number : 310-689-1811
Fax Number : 310-689-1818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2007
Last Update Date : 12/15/2007

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