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CHAN FAMILY MEDICAL CORP
NPI 1104470384
General Practice in Los Angeles, CA

Active since July 26, 2019
4070 E. OLYMPIC BLVD, LOS ANGELES, CA 90023(323) 685-2070(323) 685-2077 Get Directions Write a Review

NPPES record last updated: July 26, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Chan Family Medical Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAN FAMILY MEDICAL CORP (NPI 1104470384), doing business as Shiny Star Medical Center, is a healthcare organization registered as a general practice in Los Angeles, California and active in the NPI registry since July 2019. The organization lists Emmeline Chan, Vice President, as its authorized official.

NPPES Registry Identity

NPI1104470384
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCHAN FAMILY MEDICAL CORP
Location Address4070 E. OLYMPIC BLVDLos Angeles, CA 90023
Mailing Address4070 E. Olympic BlvdLos Angeles, CA 90023 · (323) 685-2070 · Fax (323) 685-2077
Phone(323) 685-2070
Fax(323) 685-2077
Organization SubpartNo
Authorized OfficialEmmeline ChanVice President · (323) 685-2070
Enumeration DateJuly 26, 2019
✔ NPI 1104470384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
4070 E. OLYMPIC BLVD, Los Angeles, CA 90023
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Other Names 1

Doing Business AsShiny Star Medical Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chan Family Medical Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Chan Family Medical Corp, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Emmeline Chan, M.D
Internal Medicine
NPI 1841636784
4070 E OLYMPIC BLVD
Los Angeles, CA 90023
(626) 757-0683
✔ PECOSSame address
Freddy Lim, M.D
Internal Medicine
NPI 1902240229
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 254-3884
✔ PECOS✔ Accepts Medicare6.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chan Family Medical Corp's NPI number?

The NPI number for Chan Family Medical Corp is 1104470384. It was assigned to this organization in the NPPES registry on July 26, 2019. The provider is doing business as Shiny Star Medical Center.

Where is Chan Family Medical Corp located?

Chan Family Medical Corp is located at 4070 E. Olympic Blvd, Los Angeles, CA 90023. The listed phone number is (323) 685-2070.

What is Chan Family Medical Corp's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Chan Family Medical Corp enrolled in Medicare?

Yes. Chan Family Medical Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chan Family Medical Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Chan Family Medical Corp. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Chan Family Medical Corp was last updated on July 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.