# RAYMOND Y CHAN MD A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1467991604
- **Authorized official:** RAYMOND Y CHAN M.D. (PRESIDENT)
- **Authorized official phone:** (858) 627-9988

## Contact information

- **Practice address:** 4619 CONVOY ST, STE G, SAN DIEGO, CA 92111-2318
- **Practice address phone:** (858) 627-9988
- **Mailing address:** 4619 CONVOY ST, STE G, SAN DIEGO, CA 92111-2318
- **Mailing address phone:** (858) 627-9988

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G44249 | CA | Yes |

## Other

- **Enumeration date:** 02/21/2017
- **Last updated:** 02/23/2017