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Individual

RYAN NICHOLAS CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1310 W STEWART DR STE 503, ORANGE, CA 92868-3856
(714) 997-2224
(714) 997-1187
Mailing address
4044 SPRING LN, CORONA, CA 92883-3698
(949) 351-4006

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019033
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1128223
NCCPA
01
57966
PHYSICIAN ASSISTANT
CA
Enumeration date
09/21/2015
Last updated
06/21/2024
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