Organization Active NPI

Osmund T. Chan. M.D. a Medical Corporation

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1407115769
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G43950 Issued in CA
Legal business name
OSMUND T. CHAN. M.D. A MEDICAL CORPORATION
Practice address
711 W. College St.
Suite 202
Los Angeles, CA 90012-1163
Phone
(213) 626-8338
Fax
(213) 626-8338
NPI assigned
May 8, 2012
Last updated
May 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Osmund T. Chan, M.D.NPI 1346385663
Title
Owner
Phone
(213) 626-8338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G43950 CA Primary

Addresses

Primary practice location

711 W. College St.
Suite 202
Los Angeles, CA 90012-1163

Mailing address

711 W. College St,
Suite 202
Los Angeles, CA 90012-1163
Phone (213) 626-8338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121002000294 CA Part B Supplier - Clinic/Group Practice 2769631076 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

711 W College St
Ste 202
Los Angeles, CA 90012
Phone (213) 626-8338

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1407115769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W. COLLEGE ST,",
            "address_2": "SUITE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121163",
            "telephone_number": "213-626-8338",
            "fax_number": "213-626-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W. COLLEGE ST.",
            "address_2": "SUITE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121163",
            "telephone_number": "213-626-8338",
            "fax_number": "213-626-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSMUND T. CHAN. M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "OSMUND",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-626-8338",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G43950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.