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Organization
STACY CHAN MD INC
Active
Organization
STACY CHAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY S CHAN MD (PRESIDENT)
(510) 709-6256
Entity
Organization
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(510) 709-6256
Mailing address
858 S BEDFORD ST, UNIT 201, LOS ANGELES, CA 90035-1893
(510) 709-6256
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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