Provider Demographics
NPI:1912298217
Name:CHAN, JOANN (PA)
Entity Type:Individual
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First Name:JOANN
Middle Name:
Last Name:CHAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:4070 E OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-3332
Mailing Address - Country:US
Mailing Address - Phone:323-685-2070
Mailing Address - Fax:323-685-2077
Practice Address - Street 1:4070 E OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-3332
Practice Address - Country:US
Practice Address - Phone:323-685-2070
Practice Address - Fax:323-685-2077
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2021-12-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant