Provider Demographics
NPI:1306921705
Name:CHAN, ALBERT D (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:D
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:240 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6234
Mailing Address - Country:US
Mailing Address - Phone:209-723-2799
Mailing Address - Fax:209-723-2984
Practice Address - Street 1:240 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6234
Practice Address - Country:US
Practice Address - Phone:209-723-2799
Practice Address - Fax:209-723-2984
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82765207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1306921705Medicaid
CA00A827650Medicaid
CAI05046Medicare UPIN