Active NPI
Michele Elaine Chan, DPM
- Podiatrist
- Glendora, CA
National Provider Identifier
1730701921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E6001
- Practice address
- 130 W Route 66 Unit 66
Glendora, CA 91740-6249 - Phone
- (626) 963-0302
- NPI assigned
- May 11, 2020
- Last updated
- Dec 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E6001 | CA | Primary |
Addresses
Primary practice location
130 W Route 66 Unit 66
Glendora, CA 91740-6249
Mailing address
130 W Route 66 Unit 66
Glendora, CA 91740-6249
Phone (626) 963-0302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200930000752 | MA | Order and Referring Only - Podiatry | 4082033790 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1531 | MA | MD | Addiction (Substance Use Disorder) Counselor |
| E6001 | CA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1730701921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 W ROUTE 66 UNIT 66",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406249",
"telephone_number": "626-963-0302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W ROUTE 66 UNIT 66",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406249",
"telephone_number": "626-963-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "MICHELE",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-11",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E6001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.