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Edmond L Chan Md A Medical Corporation
Medical Specialty Clinic/Center in Poway, California
NPI 1174824221

Edmond L Chan Md A Medical Corporation is a Medical Specialty Clinic/Center based in Poway, CA and is specialized in Medical Specialty. Edmond L Chan Md A Medical Corporation practices in Poway, CA. The NPI Number for Edmond L Chan Md A Medical Corporation is 1174824221 and holds a License No. A89731 (California).

The current practice location address for Edmond L Chan Md A Medical Corporation is 15708 Pomerado Rd # N107, Poway, CA and can be reached out via phone at 858-485-5921 and via fax at 858-485-1445.

Location: 15708 Pomerado Rd # N107, Poway, CA, 92064-2066
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174824221
Provider Name
Edmond L Chan Md A Medical Corporation
Credential
Provider Entity Type
Organization
Address
15708 Pomerado Rd # N107, Poway, CA, 92064-2066
Phone Number
858-485-5921
Fax Number
858-485-1445
Provider Enumeration Date
11/05/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
EC809A 01 CA PTAN
institution
Provider Business Practice Location Address Details
Address
15708 Pomerado Rd # N107
City
Poway
State
California
Zip
92064-2066
Phone Number
858-485-5921
Fax Number
858-485-1445
person
Provider Business Mailing Address Details
Address
15708 Pomerado Rd # N107
City
Poway
State
California
Zip
92064-2066
Phone Number
858-485-5921
Fax Number
858-485-1445
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
A89731 (California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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