Individual
JACQUELINE W.L. CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
447 W EATON AVE, TRACY, CA 95376-3420
(209) 830-4063
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A92182
CA
Other
Enumeration date
07/10/2007
Last updated
05/24/2010
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