JUSTIN CHAN (NPI# 1962600650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962600650 |
| Entity Type | Individual |
| Full Name | JUSTIN CHAN |
| Credential | M. D. |
| Practice Address |
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709 |
| Mailing Address |
3841 Sunset Cove Dr Port Orange FL 32129-1909 |
| Practice Telephone | 3862544165 |
| Mailing Telephone | 3136578017 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11756 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235635624 | Justin Michael Chan | Pharmacist | 11440 Windemere Parkway, San Ramon, CA 94582 | 2018-04-04 |
| 1144508292 | Justin Nile Chan | Dentist | 6675 S Custer Rd Ste 200, Mckinney, TX 75070-1838 | 2011-07-22 |
| 1003818501 | Justin Le Chan | Family Medicine | 925 S Garfield Ave, Alhambra, CA 91801-4442 | 2005-08-15 |
| 1982220497 | Justin Chan | Dentist | 47059 Van Dyke Ave, Shelby Township, MI 48317-3357 | 2020-06-20 |
| 1316576861 | Justin Prescott Chan | Student in an Organized Health Care Education/Training Program | 101 The City Drive S, Pav. 3, 2nd Floor, Orange, CA 92868 | 2020-04-06 |
| 1750850541 | Justin Kalok Chan | Physical Medicine & Rehabilitation | 1887 Monterey Hwy Ste 200, San Jose, CA 95112-6192 | 2018-11-21 |
| 1215442082 | Justin Chan | Physical Therapist | 33 Richmond Hill Rd, Staten Island, NY 10314-5950 | 2017-12-02 |
| 1043740251 | Justin Chan | Behavioral Analyst | 1063 Mcgaw Ave Ste 100, Irvine, CA 92614-5554 | 2017-06-20 |
| 1619310208 | Justin Hwa Chan | Orthopaedic Surgery | 332 Santa Fe Dr Ste 110, Encinitas, CA 92024-5143 | 2013-04-12 |
| 1750601126 | Justin J Chan | Internal Medicine | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2010-06-08 |
| Street Address |
303 N CLYDE MORRIS BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811991227 | Halifax Hospital Medical Center | Case Management | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2005-06-13 |
| 1447860374 | Priscilla Selig | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-08-05 |
| 1770123820 | Jane Hollis | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-01-07 |
| 1619512282 | Kristin Patrice Gardner | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-11-07 |
| 1447804364 | Brenda Martin Cohen | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-29 |
| 1285296574 | Cassie C Norris | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-08 |
| 1063077667 | Jara Apperley | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-05-08 |
| 1972068153 | Sreyboth Sreng | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-02-01 |
| 1356811244 | Matthew Evans | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2018-12-04 |
| 1932679503 | Amanda Gonzalez | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063178 | Jordann Wood | Family Medicine | 1890 Lpga Blvd Ste 140, Daytona Beach, FL 32117-7131 | 2019-10-01 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| 1245636042 | Dr Ejaz Ahmed Md Pa | Family Medicine | 405 North Clyde Morris Blvd, Daytona Beach, FL 32114-2730 | 2014-11-06 |
| 1063703833 | Brittany O'dwyer Newton | Family Medicine | 201 N Clyde Morris Blvd Ste 210, Daytona Beach, FL 32114-2765 | 2011-04-27 |
| 1548498561 | Ayodeji Ladele | Family Medicine | 1410 Lpga Blvd Ste 136, Daytona Beach, FL 32117-5146 | 2009-06-29 |
| 1417182932 | Phillip Michael Mele Jr. | Family Medicine | 331 Williams Ave, Daytona Beach, FL 32118-3339 | 2009-05-28 |
| 1326280991 | Kevin Anthony Johnson | Family Medicine | 1400 Hancock Blvd, #1208, Daytona Beach, FL 32114 | 2009-03-29 |
| 1265658744 | Jessika Gil-pineda | Family Medicine | 1300 Red John Dr, Daytona Beach, FL 32124-1075 | 2007-04-17 |
| 1548381049 | Andrew Jonathan Niewald | Family Medicine | 305 Memorial Medical Pkwy Ste 502, Daytona Beach, FL 32117-5169 | 2007-04-02 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.