Healthcare Provider Details

I. General information

NPI: 1174059414
Provider Name (Legal Business Name): AIMMEE S CHIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-7920
  • Fax: 760-834-7921
Mailing address:
  • Phone: 760-834-7920
  • Fax: 760-834-7921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA163920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: