Provider Demographics
NPI:1154522340
Name:OEI, GRACE CHAN (MD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:CHAN
Last Name:OEI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:LOMA LINDA UNIVERSITY FACULTY MEDICAL GROUP
Mailing Address - Street 2:11175 CAMPUS STREET
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350
Mailing Address - Country:US
Mailing Address - Phone:909-558-4250
Mailing Address - Fax:
Practice Address - Street 1:LLUMC
Practice Address - Street 2:HOUSE STAFF OFFICE CP 21005, 11234 ANDERSON STREET
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2741
Practice Address - Country:US
Practice Address - Phone:909-558-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94619208000000X, 207R00000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine