Individual
MISS CARRIE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1520 SAN PABLO ST, SUITE 3800, LOS ANGELES, CA 90033-5310
(323) 442-6962
(323) 442-7705
Mailing address
1520 SAN PABLO ST, SUITE 3800, LOS ANGELES, CA 90033-5310
(323) 442-6962
(323) 442-7705
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
535036
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
535036
LICENSE
CA
Enumeration date
09/17/2010
Last updated
09/17/2010
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