MRS. MADONNA CHAN PA-C
NPI 1710038815
Physician Assistant - Medical in Harbor City, CA

Active since January 15, 2007PECOS EnrolledAccepts Medicare Assignment
25825 VERMONT AVE, HARBOR CITY, CA 90710(310) 325-5111 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 22, 2021, Sep 13, 2016 (2 updates tracked since 2016).

About Mrs. Madonna Chan Pa-c NPPES

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

MRS. MADONNA CHAN PA-C (NPI 1710038815) is an individual medical provider in Harbor City, California, licensed in California (PA16004) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1710038815
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. MADONNA CHANCredential: PA-C
Location Address25825 VERMONT AVEHarbor City, CA 90710-3518
Mailing Address17324 Horst AveCerritos, CA 90703-2736 · (562) 261-3998
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJanuary 15, 2007
Last NPPES UpdateDecember 22, 20212 updates tracked since enumeration
NPPES CertifiedDecember 22, 2021
NPI 1710038815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · PA16004
25825 VERMONT AVE, Harbor City, CA 90710

Other Names 1

Other Name (5)Mrs. Madonna Mangune Chan Pa-c

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Madonna Chan Pa-c 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 ID9032365564
PECOS Enrollment IDI20120815000639
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.

Obstetrics & Gynecology
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE, APT CLINIC - PARKVIEW 3RD FL, ROOM 3114
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710038815, enumerated as an "individual" on January 15, 2007.

The provider is located at 25825 VERMONT AVE HARBOR CITY, CA 90710 and the phone number is (310) 325-5111.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.