Chan, Theron Hc

Chan, Theron Hc is an individual health care provider with primary practice located at 260 Hospital Dr Suite 209, Ukiah CA 95482-4533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Chan, Theron Hc can be contacted via phone (707) 463-8000.

Contact Information

Primary practice address
260 Hospital Dr Suite 209 Ukiah CA 95482-4533
Fax: (707) 462-1111
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G36292 California

Profile Details

NPI number 1952385833
LBN Legal business name Chan, Theron Hc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2005
Last updated Jun 14th, 2011 - about 14 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 1952385833 NPPES
California MEDICAID 00G362920

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