Organization
CHANWELL MEDICAL GROUP NEVADA INC
Active
Other names
CHANWELL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY QUAN CHAN M.D (PRESIDENT)
(702) 568-0686
Entity
Organization
Contact information
Practice address
2749 SUNRIDGE HEIGHTS PKWY, HENDERSON, NV 89052-5044
(702) 568-0686
(702) 568-0687
Mailing address
3726 LAS VEGAS BLVD S UNIT 3501W, LAS VEGAS, NV 89158-4399
(408) 828-2283
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
042535
CA
261QM1300X
Multi-Specialty Clinic/Center
Primary
42535
CA
261QM1300X
Multi-Specialty Clinic/Center
A35593
CA
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
042535
CA
Other
Enumeration date
04/18/2012
Last updated
03/26/2020
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