Provider Demographics
NPI:1912656299
Name:CHAN, GARRETT JUN-HAI (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:JUN-HAI
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 EL BONITO WAY
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2225
Mailing Address - Country:US
Mailing Address - Phone:650-201-8896
Mailing Address - Fax:
Practice Address - Street 1:185 BERRY ST LBBY 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5705
Practice Address - Country:US
Practice Address - Phone:415-353-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program