JENNIFER CHAN (NPI# 1184763195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184763195 |
| Entity Type | Individual |
| Full Name | JENNIFER CHAN |
| Credential | MD |
| Practice Address |
Sandia Plastic Surgery 1020 Tijeras Ave. Ne Albuquerque NM 87106-4749 |
| Mailing Address |
Sandia Plastic Surgery 1020 Tijeras Ave Ne Albuquerque NM 87106-4749 |
| Practice Telephone | 5058426868 |
| Practice Fax Number | 5058429325 |
| Mailing Telephone | 5058426868 |
| Mailing Fax Number | 5058429325 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2010-04-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | MD2007-0451 | NM | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | MD2007-0451 | NM | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629685458 | Jennifer Chan | Physician Assistant | 57 Cliffside Dr, Daly City, CA 94015-1042 | 2020-09-25 |
| 1922618867 | Jennifer Chan | Specialist/Technologist | 1281 Calle Cecilia, San Dimas, CA 91773-4435 | 2020-08-05 |
| 1861048324 | Jennifer Chan | Optometrist | 19800 Hawthorne Blvd Ste 200, Torrance, CA 90503-1520 | 2019-08-12 |
| 1447734439 | Jennifer Tze-kei Chan | Optometrist | 120 W Bonita Ave Ste A, San Dimas, CA 91773-5000 | 2018-09-17 |
| 1326323973 | Jennifer Chan | Pharmacist | 3668 Auckland Castle St, Las Vegas, NV 89135-2816 | 2011-10-14 |
| 1295069045 | Jennifer M Chan | Dentist | Wright Patterson Afb Hospital, Wright Patterson Afb, OH 45433 | 2009-09-28 |
| 1598912321 | Jennifer Tan Chan | Internal Medicine | 6041 Cadillac Ave Ste 220, Los Angeles, CA 90034-1702 | 2008-08-22 |
| 1245364231 | Jennifer Nicole Chan | Physician Assistant | 107 Sunflower Dr, Pflugerville, TX 78660-4110 | 2007-03-14 |
| 1750372785 | Jennifer Lisa Chan | Emergency Medicine | 10 Vining St, Neville House, Boston, MA 02115-6114 | 2005-10-31 |
| 1225658768 | Jennifer Chan | Physician Assistant | 1500 S Fairfield Ave, Chicago, IL 60608-1782 | 2020-04-24 |
| Street Address |
SANDIA PLASTIC SURGERY 1020 TIJERAS AVE. NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-4749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518045657 | New Mexico Plastic | Plastic Surgery | 1020 Tijeras Ave Ne Ste 16, Albuquerque, NM 87106-4749 | 2006-11-02 |
| 1336226075 | Miguel Lorenzo Gallegos | Plastic Surgery | 8004 Constitution Pl Ne, Albuquerque, NM 87110-7628 | 2006-11-01 |
| 1124033600 | Cesar Luis Cuadros | Plastic Surgery | 8232 Louisiana Blvd Ne Ste A, Albuquerque, NM 87113-2429 | 2006-07-30 |
| 1720011315 | Aaron J Mayberry | Plastic Surgery | 7115 Prospect Pl Ne, Albuquerque, NM 87110-4313 | 2006-07-08 |
| 1871931386 | Garrett Daniel Wegerif | Plastic Surgery | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2013-06-06 |
| 1407171408 | Sandia Plastic Surgery, PC | Plastic Surgery | 801 Encino Place Ne, Suite D7, Albuquerque, NM 87102 | 2010-04-01 |
| 1043402274 | Richard Charles Gobeille | Plastic Surgery | 2601 Wyoming Blvd Ne, Suite 205, Albuquerque, NM 87112-1035 | 2007-08-12 |
| 1700076239 | Jeffrey Wu | Plastic Surgery | 2211 Lomas Blvd Ne Fl 2, Unm Surgical Plastic Surgery Clinic, Albuquerque, NM 87106-2719 | 2007-07-31 |
| 1659570950 | William G. Loutfy | Plastic Surgery | 10400 Academy Rd Ne, #230, Albuquerque, NM 87111-1229 | 2007-07-16 |
| 1215058359 | Anil Shetty | Plastic Surgery | 2211 Lomas Blvd Ne, University of New Mexico Health Sciences Center, Albuquerque, NM 87106-2719 | 2007-04-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
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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.