Provider Demographics
NPI:1255619177
Name:CHAN, HOLMAN (MD)
Entity type:Individual
Prefix:
First Name:HOLMAN
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE
Mailing Address - Street 2:STE 160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4356
Mailing Address - Country:US
Mailing Address - Phone:702-878-0393
Mailing Address - Fax:702-966-1534
Practice Address - Street 1:1505 WIGWAM PKWY
Practice Address - Street 2:#330
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8194
Practice Address - Country:US
Practice Address - Phone:702-878-0393
Practice Address - Fax:702-966-1534
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2016-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV14418207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery