Provider Demographics
NPI:1508043225
Name:BRIAN J. SCHABEL, DDS, MS & VIVIAN H. CHAN, DDS, MS, INC.
Entity Type:Organization
Organization Name:BRIAN J. SCHABEL, DDS, MS & VIVIAN H. CHAN, DDS, MS, INC.
Other - Org Name:NORTH COAST ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:HUI-WEN
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:831-426-4344
Mailing Address - Street 1:1830 41ST AVE.
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010
Mailing Address - Country:US
Mailing Address - Phone:831-426-4344
Mailing Address - Fax:831-426-5223
Practice Address - Street 1:1830 41ST AVE.
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010
Practice Address - Country:US
Practice Address - Phone:831-426-4344
Practice Address - Fax:831-426-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264032611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty