# SANNY K CHAN, MD, PHD, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1457925109
- **Authorized official:** SANNY K CHAN MD, PHD (CEO)
- **Authorized official phone:** (720) 515-9810

## Contact information

- **Practice address:** 1301 20TH ST STE 220, SANTA MONICA, CA 90404-2080
- **Practice address phone:** (310) 401-1434
- **Practice address fax:** (310) 453-8468
- **Mailing address:** 1301 20TH ST STE 220, SANTA MONICA, CA 90404-2080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/17/2021
- **Last updated:** 05/17/2021