Tracy Chan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42910 Issued in CA

Practice address

1763 Union St
San Francisco, CA 94123-4406

Phone

(415) 440-9000

Fax

(415) 440-9081

NPI assigned

Sep 5, 2013

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marissa Wang Dental Corporation

  • Public Health Dentistry
  • San Francisco, CA
  • NPI 1467107011
  NPD (past)

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1811322142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 UNION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234406",
            "telephone_number": "415-440-9000",
            "fax_number": "415-440-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 UNION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234406",
            "telephone_number": "415-440-9000",
            "fax_number": "415-440-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Chu Chan
• Terrence Chan, O.D.
• Tiffany Chan
• Tiffany K Chan, O.D.
• Tin Chan, PSY.D.
• Wah Kwan Chan, OMD
• Wai Wai Vicky Chan, MFT
• Wai-Lam Chan, M.D.
• Walton Chan
• Wei Ki Elsie Chan, PSY.D

• General Practice Dentistry in San Francisco, CA
• Providers in San Francisco, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.