Provider Demographics
NPI:1174864151
Name:KWAN, AN CHUN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AN CHUN
Middle Name:
Last Name:KWAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4872
Mailing Address - Country:US
Mailing Address - Phone:916-978-0866
Mailing Address - Fax:877-914-2220
Practice Address - Street 1:6110 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4872
Practice Address - Country:US
Practice Address - Phone:916-978-0866
Practice Address - Fax:877-914-2220
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist