Jackie Fan

NPI 1326791815 · on the registry since 2022 · sole proprietor

Practice

Address: 7901 Walker St
La Palma, CA 90623
Phone: (714) 670-6000
Organisation at this address: Tanz Wu, M.D., Inc
Alan M Heilpern Md Inc
Qiao-Ling Li, M.D., Inc.
Nandlal Manchanda,M.D.,Apc
Maged L. Ghattas, M.D., Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 14

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-06-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California