Individual
BRIAN PAK HO CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 BROOKLINE AVENUE, STONEMAN 458, BOSTON, MA 02215
(617) 667-2136
(617) 667-1728
Mailing address
330 BROOKLINE AVENUE, STONEMAN 458, BOSTON, MA 02215
(617) 667-2136
(617) 667-1728
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
277470
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100258
CPSO
—
Enumeration date
08/17/2018
Last updated
04/10/2019
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