Provider Demographics
NPI:1104851476
Name:CHAN, ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 FOXCREEK TRAIL
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89809
Mailing Address - Country:US
Mailing Address - Phone:775-826-8317
Mailing Address - Fax:775-829-0450
Practice Address - Street 1:4895 FOXCREEK TRAIL
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89809
Practice Address - Country:US
Practice Address - Phone:775-826-8317
Practice Address - Fax:775-829-0450
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist