Chan Family Medical Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CHAN FAMILY MEDICAL CORP

Practice address

4070 E. Olympic Blvd
Los Angeles, CA 90023

Phone

(323) 685-2070

Fax

(323) 685-2077

NPI assigned

Jul 26, 2019

Organization subpart

No

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

Authorized official

Name

Emmeline Chan, M.DNPI 1841636784

Title

Vice President

Phone

(323) 685-2070

Specialties & licenses 1

Addresses

Other names 1

• Shiny Star Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emmeline Chan, M.D

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1841636784
  Medicare reassignment NPD Authorized official
• Freddy Lim, M.D

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1902240229
  Medicare reassignment NPD
• Joann Chan, PA

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1912298217
  Medicare reassignment
• Cesar A Velez, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1922043587
  NPD
• Percy David Ramos, MD

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1255368809
  NPD (past)

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1104470384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 E. OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90023",
            "telephone_number": "323-685-2070",
            "fax_number": "323-685-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 E. OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90023",
            "telephone_number": "323-685-2070",
            "fax_number": "323-685-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAN FAMILY MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EMMELINE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "323-685-2070",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shiny Star Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charlie Champion
• Shanece Marie Champion
• Patricia Elizabeth Chamul, PHYSICIAN ASSISTANT
• Chan and Kimn Medical Group
• Melanie Del Carmen Chan Cowes, MD
• Sarah Chan Jordon, M.D.
• Julia S Chan-Lopez, FNP-C
• Albert Wai-Tuck Chan, MD
• Alexander Chan
• Alfie Roman D. Chan, P.T

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.