Individual
JASON THOMAS CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
465 W PUTNAM AVE, PORTERVILLE, CA 93257-3320
(559) 784-1110
Mailing address
1750 CRESTVIEW LN, ERIE, CO 80516-4029
(303) 350-0956
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
PA56770
CA
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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