Provider Demographics
NPI:1497039176
Name:CHAN, LILLIAN L (PHARMD)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:L
Last Name:CHAN
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 1:275 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3810
Mailing Address - Country:US
Mailing Address - Phone:415-362-5227
Mailing Address - Fax:415-362-5487
Practice Address - Street 1:275 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3810
Practice Address - Country:US
Practice Address - Phone:415-362-5227
Practice Address - Fax:415-362-5487
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH58116OtherCALIFORNIA PHARMACIST LICENSE