Provider Demographics
NPI:1598796096
Name:CHAN, DANNY KIEN LUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:KIEN LUNG
Last Name:CHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 JUNIPERO SERRA BLVD
Mailing Address - Street 2:SUITE #590
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1906
Mailing Address - Country:US
Mailing Address - Phone:650-756-9003
Mailing Address - Fax:650-756-9005
Practice Address - Street 1:2171 JUNIPERO SERRA BLVD
Practice Address - Street 2:SUITE #590
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1906
Practice Address - Country:US
Practice Address - Phone:650-756-9003
Practice Address - Fax:650-756-9005
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26392ZMedicare ID - Type Unspecified