Provider Demographics
NPI:1598790826
Name:PAN, LESTER CHAOWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:CHAOWEN
Last Name:PAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1740 FRUITRIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3037
Mailing Address - Country:US
Mailing Address - Phone:916-391-7200
Mailing Address - Fax:916-391-7772
Practice Address - Street 1:1740 FRUITRIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3037
Practice Address - Country:US
Practice Address - Phone:916-391-7200
Practice Address - Fax:916-391-7772
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA055280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine