Basic Information
| Provider Information | |||||||||
| NPI: | 1073681383 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAN | ||||||||
| FirstName: | PABLO | ||||||||
| MiddleName: | CHUA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1339 TOBIAS DRIVE | ||||||||
| Address2: | PABLO C CHAN MD | ||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7605408566 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 86-260 FARRINGTON HWY | ||||||||
| Address2: | |||||||||
| City: | WAINAE | ||||||||
| State: | HAWAII | ||||||||
| PostalCode: | 96792 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 8086961444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 10/15/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | 2330 | HI | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | 207Q00000X | C50269 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.