Chan, Connie

Chan, Connie is an individual health care provider with primary practice located at 4530 E Muirwood Dr Suite 105, Phoenix AZ 85048-7639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Chan, Connie can be contacted via phone (480) 961-2303.

Contact Information

Primary practice address
4530 E Muirwood Dr Suite 105 Phoenix AZ 85048-7639
Fax: (480) 961-0419
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 30337 Arizona

Profile Details

NPI number 1740252584
LBN Legal business name Chan, Connie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740252584 NPPES
Arizona Other AW2081 HEALTHNET
Arizona Other AZ0719390 HEALTHNET
Arizona MEDICAID 715302 HEALTHNET

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