Jefferson Y Chan, M.D., PH.D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

G84497 Issued in CA

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 456-6141

Fax

(714) 456-5873

NPI assigned

Apr 26, 2007

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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Regents of the University of California

  • Anatomic Pathology & Clinical Pathology Physician
  • Orange, CA
  • NPI 1174662555
  Medicare reassignment
• Regents of the University of California

  • Anatomic Pathology & Clinical Pathology Physician
  • Orange, CA
  • NPI 1558311811
  Medicare reassignment
• University of California Irvine

  • Infusion Therapy Clinic/Center
  • Irvine, CA
  • NPI 1417027475
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1871713271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513377",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513377",
            "telephone_number": "714-456-8835",
            "fax_number": "714-456-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6141",
            "fax_number": "714-456-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JEFFERSON",
        "middle_name": "Y",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "G84497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WG84497A",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G844970",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G844970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chuck Chan, DO
• Daniel M Chan, P.A.
• Hin Wai Agatha Chan
• Jamie Sun-Yu Chan
• Janelle Chan
• Joshua Mon Chan, DO, MS
• Lily Chan, DC
• Lucas Sean Chan
• Margaret Chan, PHARM.D.
• Melinda Chan, AU.D.

• Clinical Pathology/Laboratory Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Clinical Pathology/Laboratory Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.