Healthcare Provider Details

I. General information

NPI: 1134540107
Provider Name (Legal Business Name): MS. CHISHENG CHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 VAN NESS AVE STE 500
SAN FRANCISCO CA
94102-6056
US

IV. Provider business mailing address

25 VAN NESS AVE STE 500
SAN FRANCISCO CA
94102-6056
US

V. Phone/Fax

Practice location:
  • Phone: 415-437-6200
  • Fax: 415-431-0353
Mailing address:
  • Phone: 415-437-6200
  • Fax: 415-431-0353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: