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Individual
LISA CHAN
Active
Individual
LISA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27784
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
846462
—
AZ
01
—
9330092672
RR MEDICARE
AZ
01
—
ZWCGCR
GROUP MEDICARE NUMBER
AZ
Enumeration date
02/09/2006
Last updated
05/29/2008
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