Lisa Mika Chan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18236 Issued in CA

Practice address

18133 Old Trail LN
Fountain Valley, CA 92708-6859

Phone

(714) 717-2233

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thomas Health Services IncGroup PAC ID 1355748021, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Thomas Health Services Inc

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1659972099
  Medicare reassignment Care Compare group
• Harbor Psychiatry & Mental Health, Professional Corporation

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1780050054
  Medicare reassignment
• Stephens Medical Corporation

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1235839002
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1831128446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18133 OLD TRAIL LN",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086859",
            "telephone_number": "714-717-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18133 OLD TRAIL LN",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086859",
            "telephone_number": "714-717-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LISA",
        "middle_name": "MIKA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18236",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18236",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (NATIONAL PROVIDER IDENTIFICATION) NUMBER",
            "identifier": "1831128446",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chan Le Nguyen MD Inc
• Chiwai E Chan, D.O.
• David Deguire Chan, D.O.
• Doris Chan
• Julie Chan, PT, DPT
• Steven Craig Chan, D.D.S.
• Chang W. Rhee, M.D., a Professional Corporation
• Courtney Leimomi Chang Wo, BT
• David Chang, PTA
• Eunice Chang, BEHAVIORAL TECHNICIA

• Physician Assistant in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.