Kathleen Chan, PHARMD
Individual provider Active NPI Pharmacist · Winterhaven, CA
NPI 1003124041 · NPPES record last updated Apr 19, 2018
Key facts
- NPI
- 1003124041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S010861 (AZ)
- Practice address
- 401 Picacho Road
Winterhaven, CA 92283 - Phone
- (760) 572-4100
- Fax
- (760) 572-2133
- NPI assigned
- Sep 23, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S010861 | AZ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S010861 | AZ | Yes |
Addresses
Primary practice location
401 Picacho Road
Winterhaven, CA 92283
Mailing address
PO Box 1368
Yuma, AZ 85365
Phone (760) 572-4100
Other providers in Winterhaven, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.