Individual
DR. LARRY C CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
685 N 13TH AVE STE 2, UPLAND, CA 91786-4963
(909) 500-8683
Mailing address
685 N 13TH AVE STE 9, UPLAND, CA 91786-4963
(909) 981-8383
(909) 920-3054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N4980
TX
207RI0011X
Interventional Cardiology Physician
006974
AZ
207RI0011X
Interventional Cardiology Physician
Primary
20A13480
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163704
—
AZ
01
—
860816346
TAX ID
AZ
Enumeration date
02/17/2010
Last updated
03/26/2026
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