Individual provider Active NPI

Lawrence W Chan, M.D.

  • Specialist
  • Sunnyvale, CA
National Provider Identifier
1669437380
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A63513 Issued in CA
Practice address
990 W Fremont Ave
Suite W
Sunnyvale, CA 94087-3021
Phone
(408) 738-0378
Fax
(408) 738-0318
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A63513 CA Primary

Addresses

Primary practice location

990 W Fremont Ave
Suite W
Sunnyvale, CA 94087-3021

Mailing address

990 W Fremont Ave
Suite W
Sunnyvale, CA 94087-3021
Phone (408) 738-0378

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000744 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2860399490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A63513CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Radiology Medical Associates, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1669437380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE",
            "address_2": "SUITE W",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873021",
            "telephone_number": "408-738-0378",
            "fax_number": "408-738-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE",
            "address_2": "SUITE W",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873021",
            "telephone_number": "408-738-0378",
            "fax_number": "408-738-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LAWRENCE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A63513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.