Dr. Jennifer L Chan, D.O.
Emergency Medicine, Emergency Medical Services in Daytona Beach, FL. Individual provider (NPI-1).
NPI number1376870048
StatusActive
Last updated in NPPESSep 30, 2021
Details
- NPI
- 1376870048
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jennifer L Chan
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 17, 2009
- Certification date
- Sep 30, 2021
- Last updated
- Sep 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207PE0004X | Emergency Medicine, Emergency Medical Services | OS14070 | FL | Yes |
| 207PE0004X | Emergency Medicine, Emergency Medical Services | 25mb09216400 | NJ | |
| 208M00000X | Hospitalist | OS14070 | FL |
Practice location
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-254-4000
Mailing address
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-254-4000
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