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Individual

CHIWAI E CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
11160 WARNER AVE, 417, FOUNTAIN VALLEY, CA 92708-4008
(714) 424-9300
(714) 424-9324
Mailing address
11160 WARNER AVE, 417, FOUNTAIN VALLEY, CA 92708-8703
(714) 424-9300
(714) 424-9324

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
4242
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
20A8068
CA

Other

Enumeration date
11/23/2005
Last updated
12/18/2020
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