Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer R. Chan, MD

Individual provider Family Medicine Physician · NPI 1396756102

Jennifer R. Chan, MD is a Family Practice in Hawthorne, California. Graduated from Ohio State University College of Medicine in 2002, 24 years ago. Practices with Providence Medical Institute, a 336-clinician group and accepts Medicare assignment. Licensed in California and Hawaii.

Years since qualifying
24
Trained at
Ohio State University College of Medicine
Licensed in
CA, HI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12618 Hawthorne Blvd
Hawthorne, CA 90250-2325
Phone: (310) 263-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A92325 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence MD12989 (HI)

Record details

NPI number1396756102
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 10, 2006
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Providence Medical Institute — 336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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