Individual provider Active NPI

Daniel M Chan, P.A.

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1871671420
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12825 Issued in CA
Practice address
2501 E Chapman Ave
Orange, CA 92869-3204
Phone
(714) 633-1011
Fax
(714) 633-4883
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12825 CA Primary

Addresses

Primary practice location

2501 E Chapman Ave
Orange, CA 92869-3204

Mailing address

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-1011

Other practice location 1

2251 N Harbor Blvd
Fullerton, CA 92835-2601
Phone (714) 449-6230

Other names 1

  • Daniel Martin Chan Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dchan1373801@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120726000691 CA Practitioner - Physician Assistant 5092971523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 633-1011

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

363 S Main St
Suite 110
Orange, CA 92868-3813
Phone (714) 855-3602

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 602-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12825CAMDAcupuncturist
PA12825CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jun 3, 2012 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

2501 E Chapman Ave
Orange, CA 92869
Phone (714) 628-3300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1871671420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-633-1011",
            "fax_number": "714-633-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-633-1011",
            "fax_number": "714-633-4883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2251 N Harbor Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928352601",
            "country_code": "US",
            "telephone_number": "714-449-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dchan1373801@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "CHAN",
            "middle_name": "MARTIN",
            "credential": "P.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.