Provider Demographics
NPI:1093417875
Name:CHAN, LINA (MD)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 PHILIPS FARM RD FL 2
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-0067
Mailing Address - Country:US
Mailing Address - Phone:573-882-4800
Mailing Address - Fax:
Practice Address - Street 1:4230 PHILIPS FARM RD FL 2
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-0067
Practice Address - Country:US
Practice Address - Phone:573-882-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program