Chan Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

A257340 Issued in CA

Legal business name

CHAN MEDICAL GROUP

Practice address

600 W I St
Suite C
Los Banos, CA 93635-3460

Phone

(209) 826-4771

Fax

(209) 826-8565

NPI assigned

Nov 6, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wan Hor Chan, M.D.NPI 1912920430

Title

President

Phone

(209) 826-4771

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wan Hor Chan, M.D.

  • Specialist
  • Los Banos, CA
  • NPI 1912920430
  NPD (past) Authorized official

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1821177031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W I ST",
            "address_2": "SUITE C",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353460",
            "telephone_number": "209-826-4771",
            "fax_number": "209-826-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W I ST",
            "address_2": "SUITE C",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353460",
            "telephone_number": "209-826-4771",
            "fax_number": "209-826-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "WAN",
        "authorized_official_middle_name": "HOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-826-4771",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A257340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76229Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Valley Pro Wash LLC (Interior Exterior Cleaning Pros.)
• Cep America - California (Vituity)
• Heaven Cerda
• Annabel Cerna, RDH
• Montserrat Ceron
• Wan Hor Chan, M.D.
• David Chang
• Stephanie J Chavez
• Coh Services Incorporated (Camarena Occupational Health)
• Eric Collinson

• Specialist in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.