Organization
CHANWELL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTRELLITA L CHAN M.D. (VICE PRESIDENT)
(408) 270-8668
Entity
Organization
Contact information
Practice address
2690 SOUTH WHITE ROAD, SUITE 10, SAN JOSE, CA 95148-2075
(408) 270-8668
(408) 270-8669
Mailing address
1715 LUNDY AVE, SUITE 174, SAN JOSE, CA 95131-1837
(408) 436-5588
(408) 436-5487
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A35593
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0052601
—
CA
Enumeration date
07/25/2006
Last updated
04/16/2008
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