Provider Demographics
NPI:1093129892
Name:CHAN, STEPHANIE HOI-LING (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:HOI-LING
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 1:21143 HAWTHORNE BLVD # 251
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4615
Mailing Address - Country:US
Mailing Address - Phone:424-587-0863
Mailing Address - Fax:
Practice Address - Street 1:3727 W 6TH ST STE 411
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5112
Practice Address - Country:US
Practice Address - Phone:424-587-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1324652084P0800X, 2084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty