Healthcare Provider Details

I. General information

NPI: 1124543327
Provider Name (Legal Business Name): LAUREN KAY CHIN RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 02/20/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 303
SAN FRANCISCO CA
94115-2376
US

IV. Provider business mailing address

2100 WEBSTER ST STE 303
SAN FRANCISCO CA
94115-2376
US

V. Phone/Fax

Practice location:
  • Phone: 415-310-9016
  • Fax: 415-923-3845
Mailing address:
  • Phone: 415-923-3867
  • Fax: 415-923-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: