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Individual
FREDDY CHAN
Active
Individual
FREDDY CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
PA17266
CA
207X00000X
Orthopaedic Surgery Physician
PA17266
CA
363A00000X
Physician Assistant
Primary
PA17266
CA
363AM0700X
Medical Physician Assistant
PA17266
CA
363AS0400X
Surgical Physician Assistant
PA17266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00PA172660
—
CA
01
—
PA17266
STATE LICENSE NUMBER
CA
Enumeration date
08/30/2006
Last updated
03/07/2023
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