Kevin W Chan, MD

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

G70023 Issued in CA

Practice address

9300 Tech Center Dr Ste 210
Sacramento, CA 95826-2589

Phone

(916) 379-9300

NPI assigned

Mar 14, 2007

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

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

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1790818177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 TECH CENTER DR STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262589",
            "telephone_number": "916-379-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 TECH CENTER DR STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262589",
            "telephone_number": "916-379-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KEVIN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "G70023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacinda Chan
• Jeddy Chan
• Jessica Chan
• Jonathan Chan
• Kelly J Chan, MD
• Lawrence Siu-Yung Chan, M.D., M.H.A.
• Melanie Chan, MPH, RD, CNSC
• Melissa Pearl Chan
• Michael Chan, M.D.
• Michelle Chan, PH.D.

• Forensic Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Forensic Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.