Chan, Edwin
Chan, Edwin is an sole proprietor health care provider with primary practice located at 1810 Eldron Blvd Se , Palm Bay FL 32909-6831. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Chan, Edwin can be contacted via phone (321) 576-0645.Contact Information
Primary practice address
1810 Eldron Blvd Se
Palm Bay FL 32909-6831
Phone: (321) 576-0645
Fax: (321) 409-6812
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME104439 | Florida |
Profile Details
| NPI number | 1124142054 |
|---|---|
| LBN Legal business name | Chan, Edwin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 17th, 2007 |
| Last updated | Sep 11th, 2025 - about last year |
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 | 1124142054 | NPPES |
| Florida | Other | VB775 | MEDICARE HF |
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