Kenneth Mankin Chan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G69784 Issued in CA

Practice address

207 S Santa Anita Ave
San Gabriel, CA 91776-1146

Phone

(626) 943-3229

Fax

(626) 943-3251

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garfield Health CenterGroup PAC ID 5597714766, shared by 3 NPIs, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kennethchan@hcpca.allscriptsdirect.net
• Direct secure messaging: kenneth.chan.p1@direct.cscla.nextgenshare.com
• Direct secure messaging: kenneth.chan@662570498326532.direct.elationemr.com

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.

• Amg, a Professional Medical Corporation

  • Internal Medicine Physician
  • Alhambra, CA
  • NPI 1558306266
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Chinatown Service Center

  • Case Manager/Care Coordinator
  • Alhambra, CA
  • NPI 1134482326
  NPD
• Chinatown Service Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1427046754
  NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1861422370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5637",
            "fax_number": "818-837-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S SANTA ANITA AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761146",
            "telephone_number": "626-943-3229",
            "fax_number": "626-943-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KENNETH",
        "middle_name": "MANKIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G69784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G697840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doris Chan, NP
• Garry D Chan, O.D.
• Ho Chan
• Jennifer Chan, PPS
• Jennifer Tak Yin Chan, PA
• Luke K Chan, M.D.
• Michelle L. Chan, M.D.
• Roger S Chan, L.AC
• Steven Chan
• William W Chan, D.C.

• Internal Medicine Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.