DR. SOPHIA CHAN M.D.
NPI 1619420767
Student in an Organized Health Care Education/Training Program in Colton, CA

Q: What is Sophia Chan's NPI number?

The NPI number for Sophia Chan is 1619420767. It was assigned to this individual provider in the NPPES registry on July 25, 2016.

Q: What is Sophia 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 Sophia Chan was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 25, 2016PECOS EnrolledAccepts Medicare Assignment

400 N PEPPER AVE, COLTON, CA 92324(855) 422-8029 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Sophia Chan M.d. NPPES

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

DR. SOPHIA CHAN M.D. (NPI 1619420767) is an individual student in an organized health care education/training program in Colton, California and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1619420767

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. SOPHIA CHANCredential: M.D.

Location Address400 N PEPPER AVEColton, CA 92324-1801

Mailing Address400 N Pepper AveColton, CA 92324-1801 · (855) 422-8029

Phone(855) 422-8029

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateJuly 25, 2016

Last NPPES UpdateFebruary 11, 2022

✔ NPI 1619420767 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.

400 N PEPPER AVE, Colton, CA 92324

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sophia Chan M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981942323

PECOS Enrollment IDI20190211002521

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.

Medicare Billing Reassignment

Medicare enrollment records show Sophia Chan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

345 mi

Internal Medicine

710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1073606299 (408) 851-1000

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

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.

CATHERINE J CALHOUN

Licensed Psychiatric Technician