Healthcare Provider Details
I. General information
NPI: 1811093305
Provider Name (Legal Business Name): TERRY CHIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US
IV. Provider business mailing address
PO BOX 1307
LONG BEACH CA
90801-1307
US
V. Phone/Fax
- Phone: 562-933-8740
- Fax:
- Phone: 562-933-8740
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | C40246 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | C40246 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: