person
Jackie Chan, DPM
Foot & Ankle Surgery Podiatrist in Pico Rivera, California
NPI 1417026881

Jackie Chan is a Foot & Ankle Surgery Podiatrist based in Pico Rivera, CA and is specialized in Foot & Ankle Surgery. Jackie Chan practices in Pico Rivera, CA and has the professional credentials of DPM. The NPI Number for Jackie Chan is 1417026881 and holds a License No. E2120 (California).

The current practice location address for Jackie Chan is 8337 Telegraph Rd, Pico Rivera, CA and can be reached out via phone at 562-806-1862 and via fax at 562-928-6542.

Location: 8337 Telegraph Rd, Pico Rivera, CA, 90660-4909
person
Provider Profile Details
NPI Number
1417026881
Provider Name
Jackie Chan
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
8337 Telegraph Rd, Pico Rivera, CA, 90660-4909
Phone Number
562-806-1862
Fax Number
562-928-6542
Provider Enumeration Date
11/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00021200 05 CA
E2120 01 CA CA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
8337 Telegraph Rd
City
State
Zip
90660-4909
Phone Number
562-806-1862
Fax Number
562-928-6542
person
Provider Business Mailing Address Details
Address
8337 Telegraph Rd
City
State
Zip
90660-4909
Phone Number
562-806-1862
Fax Number
562-928-6542
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
E2120 (California)
Definition
Definition to come...
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