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Organization
SHIRLEY M CHAN M D A MEDICAL CORPORATION
Active
Organization
SHIRLEY M CHAN M D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY M CHAN (PRESIDENT)
(818) 243-8431
Entity
Organization
Contact information
Practice address
1505 WILSON TERRACE, STE 350, GLENDALE, CA 91206-4072
(818) 243-8431
(818) 247-9239
Mailing address
PO BOX 80305, CITY OF INDUSTRY, CA 91716-8305
(818) 243-8431
(818) 247-9239
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G58168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G581680
—
CA
Enumeration date
04/24/2006
Last updated
06/23/2015
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