Provider Demographics
NPI:1679646723
Name:CHAN, ROMY HING KWAN (PT, DPT, MS, OCS)
Entity Type:Individual
Prefix:DR
First Name:ROMY
Middle Name:HING KWAN
Last Name:CHAN
Suffix:
Gender:M
Credentials:PT, DPT, MS, OCS
Other - Prefix:
Other - First Name:HING KWAN
Other - Middle Name:
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT, MS, OCS
Mailing Address - Street 1:1360 9TH AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2373
Mailing Address - Country:US
Mailing Address - Phone:415-528-7188
Mailing Address - Fax:
Practice Address - Street 1:1360 9TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2373
Practice Address - Country:US
Practice Address - Phone:415-528-7188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist