Provider Demographics
NPI:1831427400
Name:CHAN, ANA BERTHA (COMMUNITY WORKER)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:BERTHA
Last Name:CHAN
Suffix:
Gender:F
Credentials:COMMUNITY WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COMMONWEALTH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4001
Mailing Address - Country:US
Mailing Address - Phone:213-739-2301
Mailing Address - Fax:
Practice Address - Street 1:600 S COMMONWEALTH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4001
Practice Address - Country:US
Practice Address - Phone:213-739-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker