Provider Demographics
NPI:1902625676
Name:CHAN, HANNAH H (RPH)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:H
Last Name:CHAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 STANTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-3240
Mailing Address - Country:US
Mailing Address - Phone:408-204-3575
Mailing Address - Fax:
Practice Address - Street 1:1442 STANTON WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-3240
Practice Address - Country:US
Practice Address - Phone:408-204-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA042133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist