Chan, Jennifer R.

Chan, Jennifer R. is an individual health care provider with primary practice located at 12618 Hawthorne Blvd. , Hawthorne CA 90250-2325. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Chan, Jennifer R. can be contacted via phone (310) 263-5700.

Contact Information

Primary practice address
12618 Hawthorne Blvd. Hawthorne CA 90250-2325
Phone: (310) 263-5700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD12989 Hawaii
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A92325 California

Profile Details

NPI number 1396756102
LBN Legal business name Chan, Jennifer R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Jul 21st, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396756102 NPPES
Hawaii MEDICAID 088054-01

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