Provider Demographics
NPI:1508001082
Name:CHAN, REX MAN CHUN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:MAN CHUN
Last Name:CHAN
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11827 POCASSET DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-1906
Mailing Address - Country:US
Mailing Address - Phone:562-822-2383
Mailing Address - Fax:
Practice Address - Street 1:11827 POCASSET DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-1906
Practice Address - Country:US
Practice Address - Phone:562-822-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16999235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist