Michelle K.C. Fan, PH.D (O.M.D.)

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC4484 Issued in CA

Practice address

777 Campus Commons Road
Suite 160
Sacramento, CA 95825

Phone

(916) 929-6778

Fax

(916) 929-6976

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Michelle Fan NG Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1003900598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CAMPUS COMMONS ROAD",
            "address_2": "SUITE 160",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-929-6778",
            "fax_number": "916-929-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CAMPUS COMMONS ROAD",
            "address_2": "SUITE 160",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-929-6778",
            "fax_number": "916-929-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "MICHELLE",
        "middle_name": "K.C.",
        "name_prefix": "Dr.",
        "credential": "PH.D (O.M.D.)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC4484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC0044840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "NG",
            "middle_name": "FAN",
            "prefix": "DR.",
            "credential": "OMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angelita Fan, RD, MS, CDE, BC-ADM
• April Fan, FNP
• Dali Fan, M.D.
• Guinea Singh Fan, M.D.
• Jennifer J Fan, M.D.
• Wei Fan, MD
• Ghaneh Fananapazir, MD
• Tonya Fancher, MD
• Bryan L. Fandrich, MD
• Buddy Xou Fang, PHARM.D

• Acupuncturist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.