Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A103961 | CA |
Y | 2080P0205X | Pediatric Endocrinologist | 51068 | CO |
NPI | 1477718211 |
---|---|
Provider Name | Dr. Christine L Chan |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2008 |
Last Update Date | 11/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35489375 | (05) | CO |