Active NPI
Kelvin W Chan, PHARMD
- Pharmacist
- Fremont, CA
National Provider Identifier
1790940112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 47275
- Practice address
- 39400 Paseo Padre Parkway
3Rd Floor Niles Pharamcy
Fremont, CA 94538 - Phone
- (510) 248-3983
- Fax
- (510) 248-3402
- NPI assigned
- Jul 24, 2008
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 47275 | CA | Primary |
Addresses
Primary practice location
39400 Paseo Padre Parkway
3Rd Floor Niles Pharamcy
Fremont, CA 94538
Mailing address
39400 Paseo Padre Parkway
3Rd Floor Niles Pharamcy
Fremont, CA 94536
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47275 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216857600000",
"number": "1790940112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PARKWAY",
"address_2": "3RD FLOOR NILES PHARAMCY",
"city": "FREMONT",
"state": "CA",
"postal_code": "94536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PARKWAY",
"address_2": "3RD FLOOR NILES PHARAMCY",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-248-3983",
"fax_number": "510-248-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "KELVIN",
"middle_name": "W",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-24",
"last_updated": "2008-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "47275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.