Samuel Chan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G26972 Issued in CA

Practice address

13091 Kerry St
Garden Grove, CA 92844-1638

Phone

(714) 638-8811

Fax

(714) 638-2799

NPI assigned

Oct 18, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: samuel.chan@4270.securemail.prognocis.com

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1841371200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13091 KERRY ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441638",
            "telephone_number": "714-638-8811",
            "fax_number": "714-638-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13091 KERRY ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441638",
            "telephone_number": "714-638-8811",
            "fax_number": "714-638-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G26972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Chan
• David Mathias Chan, L. AC.
• Gary Chan
• Jennifer Nguyen Chan, D.O.
• Jonathan Chan, DPT
• Stacie T Chan, COTA
• Tino Chan
• Sunita Chand
• Adam Chandler
• Emma Elizabeth Chandler

• Family Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.