Provider Demographics
NPI:1245395714
Name:GABUCAN, SCHAUN CHAN (DMD)
Entity type:Individual
Prefix:DR
First Name:SCHAUN
Middle Name:CHAN
Last Name:GABUCAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-1744
Mailing Address - Country:US
Mailing Address - Phone:408-315-1181
Mailing Address - Fax:
Practice Address - Street 1:1693 FLANIGAN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1683
Practice Address - Country:US
Practice Address - Phone:408-315-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist