Edmond Chan, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G41561 Issued in CA

Practice address

15708 Pomerado Rd
Suite N107
Poway, CA 92064-2066

Phone

(858) 485-5921

Fax

(858) 485-1445

NPI assigned

Oct 20, 2005

Last updated

Nov 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: echan34016@sharphealthcare.direct-ci.com

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1699764761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15708 POMERADO RD",
            "address_2": "SUITE N107",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642066",
            "telephone_number": "858-485-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15708 POMERADO RD",
            "address_2": "SUITE N107",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642066",
            "telephone_number": "858-485-5921",
            "fax_number": "858-485-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EDMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G41561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edmondchan@chaed.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "15708 Pomerado Rd",
            "address_2": "suite N107",
            "city": "Poway",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920642066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cep America - California (Vituity)
• Cep America - Intensivists PC (Vituity)
• Cep America - Psychiatry PC (Vituity)
• Liliana Cerrillo
• Lauren Chamberlin
• Oriana Chan, PT, DPT
• Aeria Chang, M.D.
• Diana Julia Chang, MD
• Helen Yuk Yu Chang, M.D.
• Connor Chappell

• Surgery Physician in Poway, CA
• Providers in Poway, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.