Individual provider Active NPI

Stella Chan, DO

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1497336879
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A21755 Issued in CA
Practice address
1110 N Blackstone Ave
Fresno, CA 93701-1016
Phone
(800) 492-4227
NPI assigned
Apr 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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 20A21755 CA Primary

Addresses

Primary practice location

1110 N Blackstone Ave
Fresno, CA 93701-1016

Mailing address

1110 N Blackstone Ave
Fresno, CA 93701-1016
Phone (800) 492-4227

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
I20240813004259 CA Practitioner - Family Practice 6103364864 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21755CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Sep 1, 2024 Accepting new patients
Clinica Sierra Vista CurrentSince Sep 1, 2024 Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

1430 Truxtun Ave
Ste 400
Bakersfield, CA 93301
Phone 6616353050 ext. 2148

Interoperability endpoints

  • Direct secure messaging: stella.chan.1@17661.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1618704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1497336879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011016",
            "telephone_number": "800-492-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011016",
            "telephone_number": "800-492-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "STELLA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-18",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.