Provider Demographics
NPI:1295980647
Name:CHAN, ROBERT CHING (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHING
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1240 S ELISEO DR STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2028
Mailing Address - Country:US
Mailing Address - Phone:415-461-4000
Mailing Address - Fax:415-461-6907
Practice Address - Street 1:1240 S ELISEO DR STE 200
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2028
Practice Address - Country:US
Practice Address - Phone:415-461-4000
Practice Address - Fax:415-461-6907
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2020-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10029337208800000X
CAA1579822088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology