Provider Demographics
NPI:1285902247
Name:CHAN, ARTHUR G (PHARM D)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:G
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 QUINTARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1157
Mailing Address - Country:US
Mailing Address - Phone:415-664-4787
Mailing Address - Fax:
Practice Address - Street 1:3201 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-2501
Practice Address - Country:US
Practice Address - Phone:415-931-6417
Practice Address - Fax:415-931-6241
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist