Organization
EDMOND L CHAN MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA A RENTERIA (OFFICE MANAGER)
(858) 485-5921
Entity
Organization
Contact information
Practice address
15708 POMERADO RD # N107, POWAY, CA 92064-2066
(858) 485-5921
(858) 485-1445
Mailing address
15708 POMERADO RD # N107, POWAY, CA 92064-2066
(858) 485-5921
(858) 485-1445
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A89731
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EC809A
PTAN
CA
Enumeration date
11/05/2010
Last updated
05/04/2015
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