| Jennifer R Chan, MD | |
|
12618 Hawthorne Blvd., Hawthorne, CA 90250-2325 | |
| (310) 263-5700 | |
| Not Available |
| Full Name | Jennifer R Chan |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 24 Years |
| Location | 12618 Hawthorne Blvd., Hawthorne, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396756102 | NPI | - | NPPES |
| 088054-01 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD12989 (Hawaii) | Secondary |
| 207Q00000X | Family Medicine | A92325 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Medical Institute | 5991609737 | 313 |
| Entity Name | Providence Medical Institute |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417915760 PECOS PAC ID: 5991609737 Enrollment ID: O20031121000910 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer R Chan, MD 12618 Hawthorne Blvd., Hawthorne, CA 90250-2325 Ph: (310) 263-5700 | Jennifer R Chan, MD 12618 Hawthorne Blvd., Hawthorne, CA 90250-2325 Ph: (310) 263-5700 |
Dr. Khalid B Khan, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 13425 Inglewood Ave, Hawthorne, CA 90250 Phone: 310-679-2201 Fax: 310-679-4236 | |
Dr. Stephan T Honda, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 2301 W El Segundo Blvd, Hawthorne, CA 90250 Phone: 323-757-2118 | |
Gregory Vanepps, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3615 Jack Northrop Ave Ste 100, Hawthorne, CA 90250 Phone: 310-300-1051 Fax: 310-300-1052 | |
Dr. Derek Frank Williams, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11633 Hawthorne Blvd, Suite 410, Hawthorne, CA 90250 Phone: 310-792-4450 Fax: 310-792-4455 | |
Janet Fahem Soliman, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11946 Hawthorne Blvd, Hawthorne, CA 90250 Phone: 310-675-1136 Fax: 310-970-1447 | |
Terry Ishihara, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5400 W Rosecrans Ave, Ste 100, Hawthorne, CA 90250 Phone: 310-643-8500 Fax: 310-297-7863 |