Individual
JOHN CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
215 W 4TH ST, PERRIS, CA 92570-2010
(951) 486-5700
(951) 486-5705
Mailing address
PO BOX 7270, MORENO VALLEY, CA 92552-7270
(951) 486-5700
(951) 486-5705
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
PA11478
CA
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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