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Individual

DR. GERALD DENNIS CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
360 SIERRA COLLEGE DR, SUITE 100, GRASS VALLEY, CA 95945-5088
(530) 273-3190
(530) 273-5541
Mailing address
360 SIERRA COLLEGE DR, SUITE 100, GRASS VALLEY, CA 95945-5088
(530) 273-3190
(530) 273-5541

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5832 T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0366860001
GROUP MEDICARE NSC
01
YYY49206Y
GROUP MEDICARE PIN
05
YYY49206Y
CA
Enumeration date
08/22/2005
Last updated
08/19/2008
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