Individual
DR. CONNIE CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
525 N GARFIELD AVE, MONTEREY PARK, CA 91754-1202
(626) 307-2129
(626) 307-2056
Mailing address
2405 ROLLING GREEN DR, SANTA MARIA, CA 93455-1525
(805) 928-5331
(805) 928-5331
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A6654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX66540
—
CA
Enumeration date
06/23/2006
Last updated
02/18/2008
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