Active NPI
Steven Richard Chan, M.D.
- Psychiatry Physician
- Palo Alto, CA
National Provider Identifier
1235497165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 127717
- Practice address
- 3801 Miranda Ave
Building 520F, Mail Code 520 Ats
Palo Alto, CA 94304 - Phone
- (650) 493-5000
- NPI assigned
- Apr 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 127717 | CA | |
| Clinical Informatics Physician | 2083C0008X | 127717 | CA | |
| Psychiatry Physician | 2084P0800X | 127717 | CA | Primary |
Addresses
Primary practice location
3801 Miranda Ave
Building 520F, Mail Code 520 Ats
Palo Alto, CA 94304
Mailing address
3801 Miranda Ave
Building 520F, Mail Code 520 Ats
Palo Alto, CA 94304-1207
Phone (650) 493-5000
Other practice location 1
2230 Stockton Blvd
Sacramento, CA 95817-1353
Phone (916) 734-2614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127717 | CA | MD | Clinical Informatics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639353600000",
"number": "1235497165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"address_2": "BUILDING 520F, MAIL CODE 520 ATS",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "650-493-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"address_2": "BUILDING 520F, MAIL CODE 520 ATS",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94304",
"telephone_number": "650-493-5000"
}
],
"practiceLocations": [
{
"address_1": "2230 Stockton Blvd",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958171353",
"country_code": "US",
"telephone_number": "916-734-2614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAN",
"first_name": "STEVEN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-28",
"last_updated": "2021-12-13",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0300X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Addiction Medicine",
"state": "CA",
"license": "127717",
"primary": false
},
{
"code": "2083C0008X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Clinical Informatics",
"state": "CA",
"license": "127717",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "127717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.