Chan, Pennapa S

Chan, Pennapa S is an individual health care provider with primary practice located at 3377 Riverbend Dr , Springfield OR 97477-8803. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Chan, Pennapa S can be contacted via phone (458) 205-6543.

Contact Information

Primary practice address
3377 Riverbend Dr Springfield OR 97477-8803
Phone: (458) 205-6543
Fax: (458) 205-6492
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 41501-020 Wisconsin
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X MD212597 Oregon

Profile Details

NPI number 1457405128
LBN Legal business name Chan, Pennapa S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Apr 28th, 2023 - about 3 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 1457405128 NPPES
Wisconsin MEDICAID 34390100
Wisconsin Other 60653

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