Provider Demographics
NPI:1871893305
Name:PAN, CHENYIN JENNY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHENYIN
Middle Name:JENNY
Last Name:PAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5104
Mailing Address - Country:US
Mailing Address - Phone:415-581-0600
Mailing Address - Fax:415-581-0507
Practice Address - Street 1:300 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5104
Practice Address - Country:US
Practice Address - Phone:415-581-0600
Practice Address - Fax:415-581-0507
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist