Chan, Nicholas T

Chan, Nicholas T is an sole proprietor health care provider with primary practice located at 228 E 3Rd Ave , San Mateo CA 94401-4015. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Chan, Nicholas T can be contacted via phone (415) 713-0674.

Contact Information

Primary practice address
228 E 3Rd Ave San Mateo CA 94401-4015
Phone: (415) 713-0674
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 11614 California

Profile Details

NPI number 1407870074
LBN Legal business name Chan, Nicholas T
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Apr 2nd, 2012 - about 12 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 1407870074 NPPES
Arizona MEDICAID SD0116140

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