Individual provider Active NPI

Ethan Chhan, INTERN RPH

  • Student in an Organized Health Care Education/Training Program
  • Ontario, CA
National Provider Identifier
1083527030
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
INT50082 Issued in CA
Practice address
2295 S Vineyard Ave
Ontario, CA 91761-7925
Phone
(866) 536-1310
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X INT50082 CA Primary

Addresses

Primary practice location

2295 S Vineyard Ave
Ontario, CA 91761-7925

Mailing address

1876 W Hampton Dr
Hanford, CA 93230-9130
Phone (559) 589-3209

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1083527030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 W HAMPTON DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932309130",
            "telephone_number": "559-589-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 S VINEYARD AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617925",
            "telephone_number": "866-536-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHHAN",
        "first_name": "ETHAN",
        "credential": "INTERN RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "INT50082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.