Provider Demographics
NPI:1033449608
Name:CHAN, BETTY LIWAH (MD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:LIWAH
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 BAY STREET
Mailing Address - Street 2:303
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M5S3A5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1033 BAY STREET
Practice Address - Street 2:303
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M5S3A5
Practice Address - Country:CA
Practice Address - Phone:416-515-0007
Practice Address - Fax:416-926-0504
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine