Chan, Larry C
Chan, Larry C is an sole proprietor health care provider with primary practice located at 685 N 13Th Ave Ste 9 , Upland CA 91786-4963. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Chan, Larry C can be contacted via phone (909) 981-8383.Contact Information
Primary practice address
685 N 13Th Ave Ste 9
Upland CA 91786-4963
Phone: (909) 981-8383
Fax: (909) 920-3054
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | N4980 | Texas |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 006974 | Arizona |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 20A13480 | California |
Profile Details
| NPI number | 1215259221 |
|---|---|
| LBN Legal business name | Chan, Larry C |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 17th, 2010 |
| Last updated | Jul 21st, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215259221 | NPPES |
| Arizona | Other | 860816346 | TAX ID |
| Arizona | MEDICAID | 163704 | TAX ID |
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