| Constant K.s. Chan M.d. Inc. | |
|
10007 State St Lynwood CA 90262-1514 | |
| (323) 566-3157 | |
| (323) 566-2676 |
| Full Name | Constant K.s. Chan M.d. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 10007 State St, Lynwood, California |
| Authorized Official Name and Position | Constant K.s. Chan (PRESIDENT) |
| Authorized Official Contact | 3235663157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constant K.s. Chan M.d. Inc. 10007 State St Lynwood CA 90262-1514 Ph: (323) 566-3157 | Constant K.s. Chan M.d. Inc. 10007 State St Lynwood CA 90262-1514 Ph: (323) 566-3157 |
| NPI Number | 1225347438 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 11/21/2012 |
| Medicare PECOS PAC ID | 8527250349 |
|---|---|
| Medicare Enrollment ID | O20101011001170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225347438 | NPI | - | NPPES |
| 00A401740 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A40174 (California) | Primary |
| Provider Name | Constant Ks Chan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730195645 PECOS PAC ID: 1557400181 Enrollment ID: I20091120000175 |
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