| NPI | 1497991566 |
|---|---|
| Professional Name | JACK CHAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15505) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 577720) |
| 163WH0200X Registered Nurse, Home Health (Licence: CA 63642) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 15505) | |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2008-12-19 |