NPIMap

Individual provider Active NPI

Edward I. Chan, MD

  • Family Medicine Physician
  • Alameda, CA
National Provider Identifier
1366425548
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A74119 Issued in CA
Practice address
2433 Central Ave
Ste a
Alameda, CA 94501-6562
Phone
(510) 521-2300
Fax
(510) 521-7947
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A74119 CA Primary

Addresses

Primary practice location

2433 Central Ave
Ste a
Alameda, CA 94501-6562

Mailing address

2433 Central Ave
Ste a
Alameda, CA 94501-6562
Phone (510) 521-2300

Other identifiers 2

IdentifierTypeStateIssuer
00A741190OtherCABLUE SHIELD OF CA PIN
00A741190MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090217000736 CA Practitioner - Family Practice 9739244252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

2433 Central Ave
Suite a
Alameda, CA 94501-4564
Phone (510) 521-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74119CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Mar 1, 2012 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Affinity Medical Group Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

2433 Central Ave
Ste A
Alameda, CA 94501
Phone (510) 521-2300

27212 Calaroga Ave
Hayward, CA 94545
Phone (510) 783-5532

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

Interoperability endpoints

  • Direct secure messaging: echan68590@direct.stanfordhealthcare.org

Organizations & group practices 4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366425548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 CENTRAL AVE",
            "address_2": "STE A",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016562",
            "telephone_number": "510-521-2300",
            "fax_number": "510-521-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 CENTRAL AVE",
            "address_2": "STE A",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016562",
            "telephone_number": "510-521-2300",
            "fax_number": "510-521-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EDWARD",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A74119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "00A741190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A741190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.