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1336782010
MARK CHAN
SANTA CLARITA, CA
NPI
1336782010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: CA 95012116)
Enumeration Date
2019-10-24
Last Update Date
2019-10-24
Business Address
MARK CHAN NP
19231 SOLEDAD CANYON RD
SANTA CLARITA, CA 91351-3367
Phone number: 661-260-3155
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Mailing Address
MARK CHAN NP
PO BOX 721552
SAN DIEGO, CA 92172-1552
Phone number: 858-752-4177
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