Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | A104102 | CA |
NPI | 1023027729 |
---|---|
Provider Name | Grace Chan |
First Address | Los Altos, CA 94022-1408 |
Second Address | Palo Alto, CA 94301-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 27/05/2020 |