Healthcare Provider Details

I. General information

NPI: 1902971088
Provider Name (Legal Business Name): MING YAN CHIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 CALIFORNIA ST SUITE 101
SAN FRANCISCO CA
94118-1725
US

IV. Provider business mailing address

3580 CALIFORNIA ST SUITE 101
SAN FRANCISCO CA
94118-1725
US

V. Phone/Fax

Practice location:
  • Phone: 415-830-3090
  • Fax: 415-520-5191
Mailing address:
  • Phone: 415-830-3090
  • Fax: 415-520-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA061482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: