Michelle L Chan a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A54786 Issued in CA

Legal business name

MICHELLE L CHAN A PROFESSIONAL CORPORATION

Practice address

1726 New Ave
San Gabriel, CA 91776-3734

Phone

(626) 943-0780

Fax

(626) 943-0200

NPI assigned

Jul 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michelle L Chan, M.D.NPI 1043326283

Title

President

Phone

(626) 943-0780

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle L. Chan, M.D.

  • Internal Medicine Physician
  • San Gabriel, CA
  • NPI 1043326283
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1427361146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 NEW AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763734",
            "telephone_number": "626-943-0780",
            "fax_number": "626-943-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 NEW AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763734",
            "telephone_number": "626-943-0780",
            "fax_number": "626-943-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE L CHAN A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-943-0780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A547860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mendez
• Nai Ching Miao
• Michael M Nishida DDS Inc
• Michael Wong PT a Professional Corporation
• Michelle KW Chen Medical Corporation
• Min Lwin DDS
• Pastor Alfredo Miranda
• Magid Bahaeldin Farpali Mirghani
• Mission Lodge Sanitarium LLC
• Kimberly Ann Mode, PTA

• Internal Medicine Physician in San Gabriel, CA
• Providers in San Gabriel, 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 Sep 14, 2010; 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.