| Chok P Wan MD Inc | |
|
2153 Pacific Ave Long Beach CA 90806-4513 | |
| (562) 599-4833 | |
| (562) 599-6366 |
| Full Name | Chok P Wan MD Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2153 Pacific Ave, Long Beach, California |
| Authorized Official Name and Position | Chok P Wan (PRESIDENT) |
| Authorized Official Contact | 5625994833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chok P Wan MD Inc Po Box 6096 Long Beach CA 90806-0096 | Chok P Wan MD Inc 2153 Pacific Ave Long Beach CA 90806-4513 Ph: (562) 599-4833 |
| NPI Number | 1336443548 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 03/20/2020 |
| Certification Date | 03/20/2020 |
| Medicare PECOS PAC ID | 7012180789 |
|---|---|
| Medicare Enrollment ID | O20111026000264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336443548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Chok P Wan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346346616 PECOS PAC ID: 0547345977 Enrollment ID: I20111026000278 |
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