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Individual
DR. TERRENCE CHAN
Active
Individual
DR. TERRENCE CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6630T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00190939
RAILROAD MEDICARE
CA
05
—
SD0066300
—
CA
Enumeration date
07/05/2006
Last updated
02/09/2012
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