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Individual
DR. JESSIE FAN
Active
Individual
DR. JESSIE FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
227596
NY
207L00000X
Anesthesiology Physician
Primary
MD27402
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274300
—
OR
05
—
8482242
—
WA
Enumeration date
01/25/2006
Last updated
02/15/2012
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