Provider Demographics
NPI:1548572381
Name:CHAN, FRANCIS LOK SHAN (DPM)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:LOK SHAN
Last Name:CHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 E 2ND ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3877
Mailing Address - Fax:909-706-3942
Practice Address - Street 1:795 E 2ND ST
Practice Address - Street 2:SUITE 7
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-3877
Practice Address - Fax:909-706-3942
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPL 60161933213ES0103X
CAE5093213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE5093OtherMEDICAL LICENSE