Healthcare Provider Details

I. General information

NPI: 1730369372
Provider Name (Legal Business Name): JUDY SOOT-CHUEN CHIN D.D.S, M.P.H
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737, WEST CECIL AVE
DELANO CA
93215
US

IV. Provider business mailing address

PO BOX 1264
LOMA LINDA CA
92354-1264
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-2345
  • Fax:
Mailing address:
  • Phone: 909-799-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number46369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: