Provider Demographics
NPI:1154681906
Name:CHAN, ANDREA ANPEI (M D)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ANPEI
Last Name:CHAN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23845 HOLMAN HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5901
Mailing Address - Country:US
Mailing Address - Phone:831-624-3579
Mailing Address - Fax:831-866-1529
Practice Address - Street 1:23845 HOLMAN HWY STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5901
Practice Address - Country:US
Practice Address - Phone:831-624-3579
Practice Address - Fax:831-866-1529
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120129208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology