Individual provider Active NPI

Edith Y Chan, L.AC.

  • Acupuncturist
  • San Francisco, CA
National Provider Identifier
1053559153
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11420 Issued in CA
Practice address
4328 Geary Blvd
San Francisco, CA 94118-3004
Phone
(415) 668-1880
Fax
(415) 668-2080
NPI assigned
Jan 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11420 CA Primary

Addresses

Primary practice location

4328 Geary Blvd
San Francisco, CA 94118-3004

Mailing address

4328 Geary Blvd
San Francisco, CA 94118-3004
Phone (415) 668-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC11420CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1053559153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 GEARY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183004",
            "telephone_number": "415-668-1880",
            "fax_number": "415-668-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 GEARY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183004",
            "telephone_number": "415-668-1880",
            "fax_number": "415-668-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EDITH",
        "middle_name": "Y",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.