Individual provider Active NPI

Andrew Steven Chan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1104975507
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
G57859 Issued in CA
Practice address
1701 E Cesar E Chavez Ave
Suite 230
Los Angeles, CA 90033-2464
Phone
(323) 226-1100
Fax
(323) 226-1101
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X G57859 CA Primary

Addresses

Primary practice location

1701 E Cesar E Chavez Ave
Suite 230
Los Angeles, CA 90033-2464

Mailing address

5823 York Blvd Ste 3
Los Angeles, CA 90042-2634
Phone (323) 255-5643

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826000163 CA Practitioner - Family PracticePractitioner - Internal Medicine 5092839191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G57859CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Specialists Medical Corporation Current Accepting new patients

Locations

1701 E Cesar E Chavez Ave
Ste 402
Los Angeles, CA 90033
Phone (323) 255-5643

1701 E Cesar E Chavez Ave
Ste 230
Los Angeles, CA 90033
Phone (323) 226-1100

5823 York Blvd
Ste 3
Los Angeles, CA 90042
Phone (323) 255-5643

5823 York Blvd
Ste 4
Los Angeles, CA 90042

815 Washington Blvd
Montebello, CA 90640
Phone (323) 255-5643

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: andrew.chan.1@24668.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1104975507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 YORK BLVD STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900422634",
            "telephone_number": "323-255-5643",
            "fax_number": "323-254-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-226-1100",
            "fax_number": "323-226-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANDREW",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G57859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.