Individual provider Active NPI

Wei Min Chan, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1619254265
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53055 Issued in CA
Practice address
1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone
(323) 644-3888
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53055 CA Primary

Addresses

Primary practice location

1530 Hillhurst Ave
Los Angeles, CA 90027-5516

Mailing address

1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone (323) 644-3880

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801001732 CA Practitioner - Physician Assistant 9739348822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone (323) 644-3880

9960 Baldwin PL
El Monte, CA 91731-2204
Phone (626) 774-2988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53055CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Doctors Center Inc Past Accepting new patients
Sussman & Staller MD PA PastSince Dec 30, 2015 Accepting new patients

Organizations & group practices 3

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": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1619254265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275516",
            "telephone_number": "323-644-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275516",
            "telephone_number": "323-644-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WEI",
        "middle_name": "MIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.