Mai-King Chrystal Chan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35121029 Issued in OH

Practice address

10833 Le Conte Ave
A2-383 MDCC
Los Angeles, CA 90095-3075

Phone

(310) 267-0119

NPI assigned

Jun 2, 2010

Last updated

Dec 14, 2016By 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 3

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mchan477387@direct.uclahealth.org

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.

• UC Regents

  dba UCLA Dept of Pediatric Grp Practice

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1982667663
  Medicare reassignment NPD
• UCLA Department of Pediatric Group Practice

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1093025355
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Pediatrics

  NPD (past)
• Northcoast Anesthesia Providers

  • General Acute Care Hospital
  • Westlake, OH
  • NPI 1174851554
  NPD (past)

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1649590662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "A2-383 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "A2-383 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-267-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MAI-KING",
        "middle_name": "CHRYSTAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35121029",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "141489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084755",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lianne Chan, PHARMD, RPH
• Lider Chan, DPT
• Linda Chan
• Lisa A Chan, D.D.S.
• Mabel Chan, RN
• May Chan
• Megan Ying Chan
• Melanie Chan
• Michael Fook CHI Chan
• Michael Low Chan

• Pediatrics Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.