Chan, Connie
Chan, Connie is an individual health care provider with primary practice located at 4530 E Muirwood Dr Suite 105, Phoenix AZ 85048-7639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Chan, Connie can be contacted via phone (480) 961-2303.Contact Information
Primary practice address
4530 E Muirwood Dr Suite 105
Phoenix AZ 85048-7639
Phone: (480) 961-2303
Fax: (480) 961-0419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 30337 | Arizona |
Profile Details
| NPI number | 1740252584 |
|---|---|
| LBN Legal business name | Chan, Connie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740252584 | NPPES |
| Arizona | Other | AW2081 | HEALTHNET |
| Arizona | Other | AZ0719390 | HEALTHNET |
| Arizona | MEDICAID | 715302 | HEALTHNET |
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