Andy M Chan, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A20352 Issued in CA

Practice address

4077 Fifth Ave # Mer35
San Diego, CA 92103-2105

Phone

(619) 294-8111

NPI assigned

Apr 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: achan318796@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scripps Health Inpatient Providers Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1699043000
  Medicare reassignment Care Compare group NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  NPD (past)
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1104480912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE # MER35",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE # MER35",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-294-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANDY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A20352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pui Yen Karina Chan Liang, PHARMD
• Alex Chan, DO
• Allen W Chan, DC
• Alyssa Chan
• Andrea Chan, PHARM.D.
• Arden Chan, M.D.
• Bill Wayne Chan, MD
• Brian Chan, D.D.S.
• Cameron F Chan, PA-C
• Candace M. Chan, M.D.

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.

Verify at the official NPI Registry.