Active NPI
Hannah Chan
- Dermatology Physician
- Phoenix, AZ
National Provider Identifier
1508712472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 67925
- Practice address
- 3100 N Central Ave
Phoenix, AZ 85012-2637 - Phone
- (602) 812-4312
- NPI assigned
- Mar 4, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 67925 | CA | Primary |
Addresses
Primary practice location
3100 N Central Ave
Phoenix, AZ 85012-2637
Mailing address
105 Pinnacle TRL
Irvine, CA 92618-4815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67925 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1508712472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 PINNACLE TRL",
"city": "IRVINE",
"state": "CA",
"postal_code": "926184815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 N CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122637",
"telephone_number": "602-812-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "HANNAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-04",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "67925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.