Individual
MR. RICKY YUK KIU CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
420 DELAWARE ST SE, CTR FOR BLD AND CLOT DISORDERS, SUITE B-549, MMC 713, MINNEAPOLIS, MN 55455-0341
(612) 626-6455
(612) 625-4955
Mailing address
420 DELAWARE ST SE, CTR FOR BLD AND CLOT DISORDERS, SUITE B-549, MMC 713, MINNEAPOLIS, MN 55455-0341
(612) 626-6455
(612) 625-4955
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9989
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206936900
—
MN
Enumeration date
04/18/2006
Last updated
06/11/2009
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