# VISOTH CHAN, D.P.M., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134781206
- **Authorized official:** MIGUEL ANGEL CHUC MS (HR)
- **Authorized official phone:** (949) 364-2525

## Contact information

- **Practice address:** 26732 CROWN VALLEY PKWY STE 317, MISSION VIEJO, CA 92691-6374
- **Practice address phone:** (949) 364-2525
- **Practice address fax:** (949) 364-3322
- **Mailing address:** 26732 CROWN VALLEY PKWY STE 317, MISSION VIEJO, CA 92691-6374
- **Mailing address phone:** (949) 364-2525
- **Mailing address fax:** (949) 364-3322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2019
- **Last updated:** 02/28/2020