Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | A94366 | CA |
NPI | 1093958555 |
---|---|
Provider Name | Dr. Ellen Chan |
First Address | San Francisco, CA 94118-1618 |
Second Address | San Francisco, CA 94118-1618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 02/06/2014 |