Individual provider Active NPI

Cecilia Y Chan, DC

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1659400455
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28634 Issued in CA
Practice address
1235 N Harbor Blvd
Ste. 111
Fullerton, CA 92832-1355
Phone
(714) 871-9080
Fax
(714) 871-4459
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28634 CA Primary

Addresses

Primary practice location

1235 N Harbor Blvd
Ste. 111
Fullerton, CA 92832-1355

Mailing address

1235 N Harbor Blvd
Ste. 111
Fullerton, CA 92832-1355
Phone (714) 871-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111101000607 CA Practitioner - Chiropractic 6901079268 Reassigns benefits to 1 organization
Practice locations: Fullerton, CA; Whittier, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1235 N Harbor Blvd
Suite 111
Fullerton, CA 92832-1323
Phone (714) 871-9080

7354 Painter Ave
Whittier, CA 90602-1853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC28634CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chan Chiropractic Healthcare Place Inc Chiropractor CurrentSince May 24, 2018 Accepting new patients
Chan Chiropractic Healthcare Place Inc Chiropractor Current Accepting new patients
Sun Acupuncture and Herb Clinic Corp Past Accepting new patients
Grigoryan Chiropractic Corp Chiropractor PastSince Apr 20, 2025 Accepting new patients

Locations

1235 N Harbor Blvd
Ste 111
Fullerton, CA 92832
Phone (714) 228-1182

7354 Painter Ave
Whittier, CA 90602
Phone (562) 464-0806

Organizations & group practices 4

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1659400455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N HARBOR BLVD",
            "address_2": "STE. 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321355",
            "telephone_number": "714-871-9080",
            "fax_number": "714-871-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N HARBOR BLVD",
            "address_2": "STE. 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321355",
            "telephone_number": "714-871-9080",
            "fax_number": "714-871-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CECILIA",
        "middle_name": "Y",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.