Individual
DR. SUISUN SIMON CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 N GARFIELD AVE, SUITE 308, MONTEREY PARK, CA 91754-1242
(626) 288-8292
(626) 288-8789
Mailing address
500 N GARFIELD AVE, SUITE 308, MONTEREY PARK, CA 91754-1242
(626) 288-8292
(626) 288-8789
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A42588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071580
—
CA
01
—
ZZZ53947Z
BLUE SHIELD
CA
Enumeration date
07/19/2006
Last updated
07/09/2007
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