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Individual

DR. KELLY CHENKAI FAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-8860
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-8860

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A133109
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A133109
CA
207RP1001X
Pulmonary Disease Physician
Primary
A133109
CA
208M00000X
Hospitalist Physician
A133109
CA

Other

Enumeration date
05/23/2013
Last updated
02/15/2022
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