Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NI0013X | Independent Medical Examiner | DC18757 | CA |
N | 111NX0100X | Occupational Health | DC18757 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC18757 | CA |
NPI | 1235345943 |
---|---|
Provider Name | Raymond Yan-Kwong Chan |
First Address | Oakland, CA 94607-3963 |
Second Address | Oakland, CA 94607-3963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH00002209 | CHIROPRACTOR (01) | WA |
DC18757 | CHIROPRACTOR (01) | CA |
MTA22600 | CLINICAL LAB.SCIENTIST (01) | CA |