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NPI Code Detail

MEDICARE: TIFFANY TING CHAN DO

MEDICARE: TIFFANY TING CHAN DO
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
1207Q00000XFamily Medicine Physician20A23689CA

General Provider Information

NPI Number : 1932803384
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY TING CHAN DO
Provider Business Mailing Address
First Line : 8627 ATLANTIC AVE
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-3501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8627 ATLANTIC AVE
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-3501
Country : US
Telephone Number : 323-312-2605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 12/10/2025

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Directions to “ TIFFANY TING CHAN DO” Practice Location

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