Active NPI
Lilian Yuet Chun Chan, NP, L.AC
- Primary Care Nurse Practitioner
- Fremont, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- NP9382
- Practice address
- 39400 Paseo Padre Pkwy
Niles Building Med 1 B
Fremont, CA 94538-2310 - Phone
- (510) 248-3884
- Fax
- (510) 248-3395
- NPI assigned
- Dec 11, 2006
- Last updated
- Dec 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 439058 | CA | |
| Acupuncturist | 171100000X | AC16060 | CA | |
| Primary Care Nurse Practitioner | 363LP2300X | NP9382 | CA | Primary |
Addresses
Primary practice location
39400 Paseo Padre Pkwy
Niles Building Med 1 B
Fremont, CA 94538-2310
Mailing address
39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 439058 | CA | MD | Registered Nurse |
| AC16060 | CA | MD | Acupuncturist |
| NP9382 | CA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current | Accepting new patients |
Locations
39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000
39400 Paseo Padre Pkwy
Bldg Med
Fremont, CA 94538
Phone (510) 248-3670
1800 Harrison St
Fl 7
Oakland, CA 94612
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1033279344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PKWY",
"address_2": "NILES BUILDING MED 1 B",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382310",
"telephone_number": "510-248-3884",
"fax_number": "510-248-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "LILIAN",
"middle_name": "YUET CHUN",
"name_prefix": "Ms.",
"credential": "NP, L.AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "439058",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC16060",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "NP9382",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "39400 Paseo Padre Pkwy",
"city": "Fremont",
"state": "CA",
"country_code": "US",
"postal_code": "945382310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.