Organization
ROXANNE CHAN, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANNE CHAN MD (PRESIDENT)
(310) 456-7828
Entity
Organization
Contact information
Practice address
15332 ANTIOCH ST, PMB #212, PACIFIC PALISADES, CA 90272-3628
(310) 456-7828
(310) 388-3089
Mailing address
15332 ANTIOCH ST, PMB #212, PACIFIC PALISADES, CA 90272-3628
(310) 456-7828
(310) 388-3089
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A82201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A822010
—
CA
Enumeration date
03/17/2008
Last updated
03/17/2008
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