Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | G57859 | CA |
NPI | 1104975507 |
---|---|
Provider Name | Dr. Andrew Steven Chan |
First Address | Los Angeles, CA 90042-2634 |
Second Address | Los Angeles, CA 90033-2464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 11/01/2018 |