Individual
ADRIENNE CAROL MAR CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1850 S AZUSA AVE STE 206, HACIENDA HEIGHTS, CA 91745-6853
(626) 810-5450
(626) 810-0391
Mailing address
PO BOX 31001-4303, PASADENA, CA 91110-0001
(858) 260-2977
(858) 332-1811
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
101049
CA
363A00000X
Physician Assistant
Primary
53152
CA
363A00000X
Physician Assistant
Primary
PA53152
CA
363AM0700X
Medical Physician Assistant
PA53152
CA
Other
Enumeration date
02/15/2016
Last updated
05/29/2026
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