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Individual
MS. LISA MIKA CHAN
Active
Individual
MS. LISA MIKA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18236
CA
363AM0700X
Medical Physician Assistant
PA18236
CA
363AS0400X
Surgical Physician Assistant
PA18236
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831128446
NPI (NATIONAL PROVIDER IDENTIFICATION) NUMBER
CA
Enumeration date
07/03/2006
Last updated
11/19/2019
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