Active NPI
Jason Thomas Chan, PA
- Emergency Medicine Physician
- Porterville, CA
National Provider Identifier
1790337145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- PA56770
- Practice address
- 465 W Putnam Ave
Porterville, CA 93257-3320 - Phone
- (559) 784-1110
- NPI assigned
- Jul 15, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | PA56770 | CA | Primary |
Addresses
Primary practice location
465 W Putnam Ave
Porterville, CA 93257-3320
Mailing address
1750 Crestview LN
Erie, CO 80516-4029
Phone (303) 350-0956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56770 | CA | MD | Pharmacist |
| PA56770 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1790337145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 CRESTVIEW LN",
"city": "ERIE",
"state": "CO",
"postal_code": "805164029",
"telephone_number": "303-350-0956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 W PUTNAM AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "932573320",
"telephone_number": "559-784-1110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JASON",
"middle_name": "THOMAS",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-15",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "PA56770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Porterville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.