Healthcare Provider Details

I. General information

NPI: 1649614595
Provider Name (Legal Business Name): GREGORY ALAN CHINN M.D./PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE # S436
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

513 PARNASSUS AVE STE S-436
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-3781
  • Fax:
Mailing address:
  • Phone: 415-514-3781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: