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NPI Code Detail

MEDICARE: DR. SIEGRIED AUDFREY FLORES CHIN MD

MEDICARE: DR. SIEGRIED AUDFREY FLORES CHIN MD
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
1207R00000XInternal Medicine PhysicianA206150CA
2390200000XStudent in an Organized Health Care Education/Training ProgramR80335AZ

General Provider Information

NPI Number : 1578295879
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIEGRIED AUDFREY FLORES CHIN MD
Provider Business Mailing Address
First Line : 3100 N CENTRAL AVE # 711D
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2637
Country : US
Telephone Number : 602-314-6617
Fax Number :
Provider Business Practice Location Address
First Line : 3 HARBOR DR STE 111
Second Line :
City : SAUSALITO
State : CA
Zip : 94965-1491
Country : US
Telephone Number : 415-683-2988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2022
Last Update Date : 05/20/2026

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