DR. HUMPHREY CHAN MD
NPI 1104715002
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since July 02, 2025PECOS Enrolled
1100 N STATE ST, LOS ANGELES, CA 90033(323) 409-4535 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Humphrey Chan Md NPPES

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

DR. HUMPHREY CHAN MD (NPI 1104715002) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104715002
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. HUMPHREY CHANCredential: MD
Location Address1100 N STATE STLos Angeles, CA 90033-5000
Mailing Address1100 N State StLos Angeles, CA 90033-5000
Sole ProprietorNo
Enumeration DateJuly 2, 2025
NPPES CertifiedJuly 2, 2025
NPI 1104715002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1100 N STATE ST, Los Angeles, CA 90033

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Humphrey Chan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Pediatrics
1100 N STATE ST, CLINIC TOWER, SUITE A7D
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Registered Nurse (Ambulatory Care)
1100 N STATE ST
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
General Acute Care Hospital
1100 N STATE ST, CLINIC TOWER A4E
LOS ANGELES, CA 90033
Registered Nurse (Ambulatory Care)
1100 N STATE ST
LOS ANGELES, CA 90033

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 Humphrey Chan's NPI number?

The NPI number for Humphrey Chan is 1104715002. It was assigned to this individual provider in the NPPES registry on July 2, 2025.

Where is Humphrey Chan located?

Humphrey Chan practices at 1100 N State St, Los Angeles, CA 90033. The listed phone number is (323) 409-4535.

What is Humphrey Chan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Humphrey Chan enrolled in Medicare?

Yes. Humphrey Chan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Humphrey Chan was last updated on July 2, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.