Shun-Chieh Jack Chan, MSN, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15505 Issued in CA

Practice address

1940 Bryant St
San Francisco, CA 94110-1409

Phone

(415) 476-6041

Fax

(415) 476-4700

NPI assigned

Dec 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mr. Jack Chan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1497991566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 BRYANT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101409",
            "telephone_number": "415-476-6041",
            "fax_number": "415-476-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 BRYANT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101409",
            "telephone_number": "415-476-6041",
            "fax_number": "415-476-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SHUN-CHIEH",
        "middle_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "MSN, NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "577720",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "63642",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15505",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "15505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "CHAN",
            "prefix": "MR.",
            "credential": "MSN, NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Selena Y. Chan, O.D.
• Sheila Chan, M.D.
• Shin Mei Chan
• Shirley Jiyin Chan, MD
• Shu Wing Chan, MD
• Siu W. Chan, DDS
• Stephen Chan, MD
• Stephen L Chan, PHARM. D
• Steven Chan
• Steven Ping Chan, MD

• Family Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.