Provider Demographics
NPI:1902606304
Name:CHAN, TINO
Entity type:Individual
Prefix:MR
First Name:TINO
Middle Name:
Last Name:CHAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8862 GARDEN GROVE BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1293
Mailing Address - Country:US
Mailing Address - Phone:657-400-4235
Mailing Address - Fax:714-786-8123
Practice Address - Street 1:8862 GARDEN GROVE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1293
Practice Address - Country:US
Practice Address - Phone:657-400-4235
Practice Address - Fax:714-786-8123
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health