Provider Demographics
NPI:1912315680
Name:CHAN, HESPER TSAI (PA-C)
Entity type:Individual
Prefix:
First Name:HESPER
Middle Name:TSAI
Last Name:CHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19582 BEACH BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2996
Mailing Address - Country:US
Mailing Address - Phone:714-841-9899
Mailing Address - Fax:949-999-8148
Practice Address - Street 1:19582 BEACH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2996
Practice Address - Country:US
Practice Address - Phone:714-841-9899
Practice Address - Fax:949-999-8148
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA51791363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant