MEDICARE: AMANDA CHIN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95025128	CA

General Provider Information

NPI Number	:	1528525458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA CHIN NP

Provider Business Mailing Address
First Line	:	24422 AVENIDA DE LA CARLOTA STE 300
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3628
Country	:	US
Telephone Number	:	949-599-2434
Fax Number	:

Provider Business Practice Location Address
First Line	:	2071 SAN JOAQUIN HILLS RD
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6505
Country	:	US
Telephone Number	:	949-759-7120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2019
Last Update Date	:	02/04/2026

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