Provider Demographics
NPI:1659671709
Name:CHAN, ALAN S (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:S
Last Name:CHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 LA PLAYA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3219
Mailing Address - Country:US
Mailing Address - Phone:415-387-0481
Mailing Address - Fax:415-387-0932
Practice Address - Street 1:850 LA PLAYA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-3219
Practice Address - Country:US
Practice Address - Phone:415-387-0481
Practice Address - Fax:415-387-0932
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist