Provider Demographics
NPI:1760454581
Name:CHAN, PERRY (PHD)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20606 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6823
Mailing Address - Country:US
Mailing Address - Phone:818-348-2547
Mailing Address - Fax:
Practice Address - Street 1:4301 LOST HILLS RD
Practice Address - Street 2:
Practice Address - City:CALABASAS HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-5358
Practice Address - Country:US
Practice Address - Phone:818-880-8040
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCHANS5207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics