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Individual

DR. DAVID CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4240 ROCKLIN RD, SUITE #3, ROCKLIN, CA 95677-2862
(916) 624-0508
(916) 624-4727
Mailing address
4240 ROCKLIN RD, SUITE #3, ROCKLIN, CA 95677-2862
(916) 624-0508
(916) 624-4727

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7755T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0868590001
DMEPOS SUPPLIER NUMBER
CA
05
SD0077550
CA
Enumeration date
10/26/2006
Last updated
07/08/2007
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