Basic Information
| Provider Information | |||||||||
| NPI: | 1598318602 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAN | ||||||||
| FirstName: | LIK HANG TOMMY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 QUARRY RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 QUARRY RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2019 | ||||||||
| LastUpdateDate: | 07/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | A163198 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.