Individual
DR. JACK FONG CHAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12212 SCULLY AVE, SARATOGA, CA 95070-3339
(408) 921-3303
Mailing address
12212 SCULLY AVE, SARATOGA, CA 95070-3339
(408) 921-3303
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G21437
CA
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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