Provider Demographics
NPI:1902183023
Name:JEFFREY DULAY CHAN
Entity Type:Organization
Organization Name:JEFFREY DULAY CHAN
Other - Org Name:HEALTHPEAK HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:619-888-3106
Mailing Address - Street 1:1450 S IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4200
Mailing Address - Country:US
Mailing Address - Phone:760-352-3108
Mailing Address - Fax:760-352-3234
Practice Address - Street 1:1450 S IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4200
Practice Address - Country:US
Practice Address - Phone:760-352-3108
Practice Address - Fax:760-352-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health