Ellie Eiei Chan, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A110958 Issued in CA

Practice address

2335 E Kashian LN
Suite 301
Fresno, CA 93701-2230

Phone

(559) 256-9680

Fax

(559) 256-9681

NPI assigned

Jul 10, 2007

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Fanny Chan Other name

Electronic endpoints 1

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

Specialty

Hematology/OncologyAlso: Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Hospice-Santa Clara Hospice, Santa Clara, CA, CCN 051589

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• University Faculty Associates, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1235537283
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Hospice-Santa Clara

  • Community Based Hospice Care Agency
  • Santa Clara, CA
  • NPI 1841364247
  Care Compare affiliation

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1578761656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 E KASHIAN LN",
            "address_2": "SUITE 301",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012230",
            "telephone_number": "559-256-9680",
            "fax_number": "559-256-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ELLIE",
        "middle_name": "EIEI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A110958",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CA",
            "license": "A110958",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A110958",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A110958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LIC",
            "identifier": "LL1774",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1150 Veterans Blvd",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940632037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "FANNY",
            "last_name": "CHAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nathan Samuel Champion
• Patricia Champlin
• Chan Lee Professional Corporation (Chan Lee Weight Loss and Wellness Center)
• Ada Wai Chan, M.D.
• Chun-Wai Chan, MD
• Gary Chan, M.D.
• Geny-Ana R. Chan, DDS
• Henry R Chan, DDS
• Joelle Chan
• Lenon Chan

• Hematology & Oncology Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.