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
10615 S DE ANZA BLVD, CUPERTINO, CA 95014-4431
(408) 343-0888
(408) 343-0688
Mailing address
10615 S DE ANZA BLVD, CUPERTINO, CA 95014-4431
(408) 343-0888
(408) 343-0688
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0052602
—
CA
Enumeration date
09/06/2006
Last updated
02/21/2008
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