KELLY LANI CHAN
NPI 1174125777
Student in an Organized Health Care Education/Training Program in San Diego, CA

Q: What is Kelly Chan's NPI number?

The NPI number for Kelly Chan is 1174125777. It was assigned to this individual provider in the NPPES registry on November 10, 2020.

Q: What is Kelly Chan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Chan was last updated on November 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since November 10, 2020

6405 MIRA MESA BLVD STE 210, SAN DIEGO, CA 92121(866) 701-6565 Get Directions Write a Review

NPPES record last updated: November 10, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Kelly Lani Chan NPPES

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

KELLY LANI CHAN (NPI 1174125777) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1174125777

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKELLY LANI CHAN

Location Address6405 MIRA MESA BLVD STE 210San Diego, CA 92121-4146

Mailing Address6405 Mira Mesa Blvd Ste 210San Diego, CA 92121-4146

Phone(866) 701-6565

Sole ProprietorNo

Enumeration DateNovember 10, 2020

NPPES CertifiedNovember 5, 2020

✔ NPI 1174125777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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.

6405 MIRA MESA BLVD STE 210, San Diego, CA 92121

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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.

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