Eric Siu Ping Chan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A51580 Issued in CA

Practice address

1057 E Grand Ave
Arroyo Grande, CA 93420-2504

Phone

(626) 927-0874

Fax

(626) 927-0875

NPI assigned

Oct 12, 2006

Last updated

Sep 29, 2022By 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 2

Addresses

Other identifiers 2

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

Specialty

Obstetrics/Gynecology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gracelight Community HealthGroup PAC ID 3072619618, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment Care Compare group NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Oceano, CA
  • NPI 1336166248
  Medicare reassignment NPD
• Eric S.P. Chan, M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Monterey Park, CA
  • NPI 1053644021
  Authorized official Same address or phone
• Community Health Centers of the Central Coast Inc

  dba Community Health Centers Del Valle

  • Clinic/Center
  • Santa Maria, CA
  • NPI 1174911317
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • San Luis Obispo, CA
  • NPI 1275553257
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1447277355
  NPD
• Community Health Centers of the Central Coast Inc

  dba Community Health Centers Cambria

  • Federally Qualified Health Center (FQHC)
  • Cambria, CA
  • NPI 1881611705
  NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1639241888
  NPD
• Ahmc Garfield Medical Center LP

  dba Garfield Medical Center

  • General Acute Care Hospital
  • Monterey Park, CA
  • NPI 1730171265
  NPD (past)
• Ahmc Greater El Monte Comm Hosp LLC

  dba Greater El Monte Comm Hosp

  • Community/Retail Pharmacy
  • South El Monte, CA
  • NPI 1922115526
  NPD (past)
• Ahmc San Gabriel Valley Medical

  dba AHMC San Gabriel Valley Medical Center

  • Skilled Nursing Facility
  • San Gabriel, CA
  • NPI 1710174818
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1780773044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 E GRAND AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202504",
            "telephone_number": "626-927-0874",
            "fax_number": "626-927-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ERIC",
        "middle_name": "SIU PING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A51580",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A51580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A515800",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CARE SUB",
            "identifier": "000026089",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Coast Retina Inc
• Central Coast Speech Pathology and Orofacial Myology
• Central Coast Spine and Pain Management Center, Inc.
• Cep America - Anesthesia PC
• Cep America - California (Vituity)
• G Chan, PHARMD
• Janel A Chavez, LCSW
• Sherry Leigh Christensen, PHARMACY TECHNICIAN
• Timothy Levi Christopher, PT, DPT
• Nicole Chung, DMD

• Obstetrics & Gynecology Physician in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
• 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.