Chan, Jennifer L

Chan, Jennifer L is an individual health care provider with primary practice located at 303 N Clyde Morris Blvd , Daytona Beach FL 32114-2709. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Chan, Jennifer L can be contacted via phone (386) 254-4000.

Contact Information

Primary practice address
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709
Phone: (386) 254-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 25MB09216400 New Jersey
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X OS14070 Florida
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X OS14070 Florida

Profile Details

NPI number 1376870048
LBN Legal business name Chan, Jennifer L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2009
Last updated Sep 30th, 2021 - about 3 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 1376870048 NPPES
New Jersey MEDICAID 1376780048

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