Individual provider Active NPI

Justin Le Chan, M.D.

  • Family Medicine Physician
  • Alhambra, CA
National Provider Identifier
1003818501
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G79829 Issued in CA
Practice address
925 S Garfield Ave
Alhambra, CA 91801-4442
Phone
(626) 282-0282
Fax
(626) 282-0939
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G79829 CA Primary

Addresses

Primary practice location

925 S Garfield Ave
Alhambra, CA 91801-4442

Mailing address

333 S Garfield Ave
Suite K
Alhambra, CA 91801-3800
Phone (626) 282-8046

Other identifiers 1

IdentifierTypeStateIssuer
00G798290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000598 CA Practitioner - Internal Medicine 8820095524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amg a Professional Medical CorporationGroup PAC ID 9830092279, 27 clinicians

Practice addresses (Care Compare)

1658 W Valley Blvd
Suite 120
Alhambra, CA 91803-2370
Phone (626) 282-0282

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G79829CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg, a Professional Medical Corporation Family Medicine CurrentSince Apr 1, 2006 Accepting new patients

Locations

1658 W Valley Blvd
Ste 120
Alhambra, CA 91803

333 S Garfield Ave
Ste A
Alhambra, CA 91801
Phone (626) 284-1997

925 S Garfield Ave
Alhambra, CA 91801
Phone (626) 300-8388

710 N Euclid St
Ste 101
Anaheim, CA 92801
Phone (714) 517-2000

455 N Garfield Ave
Fl 2
Monterey Park, CA 91754
Phone (626) 307-1133

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: justin.chan@aapmc-ca.direct.office.nextgen.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003818501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S GARFIELD AVE",
            "address_2": "SUITE K",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013800",
            "telephone_number": "626-282-8046",
            "fax_number": "626-289-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S GARFIELD AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918014442",
            "telephone_number": "626-282-0282",
            "fax_number": "626-282-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JUSTIN",
        "middle_name": "LE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G798290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.