Individual
MS. THERESA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2825 E BARNETT ROAD, ROGUE VALLEY MEDICAL CENTER, MEDFORD, OR 97504
(541) 789-7000
Mailing address
2640 E BARNETT ROAD, #E-333 SOUTHERN OREGON HOSPITALISTS, PC, MEDFORD, OR 97504
(541) 282-6770
(541) 282-6771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A83176
CA
207Q00000X
Family Medicine Physician
Primary
MD152431
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A831760
—
CA
Enumeration date
06/15/2006
Last updated
06/23/2011
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