Individual
DR. JACKIE TSZ-KIT CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
413 E ORANGEBURG AVE STE A, MODESTO, CA 95350-5369
(209) 529-4422
(209) 529-1711
Mailing address
4120 DALE RD, STE J-8 #232, MODESTO, CA 95356-9239
(209) 529-4422
(209) 529-1711
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
G077865
CA
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
G077865
CA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G077865
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
G077865
CA
208VP0014X
Interventional Pain Medicine Physician
G077865
CA
Other
Enumeration date
04/14/2006
Last updated
08/24/2023
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