Healthcare Provider Details

I. General information

NPI: 1881102002
Provider Name (Legal Business Name): CALVIN CHIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 CAPITOLA RD
SANTA CRUZ CA
95062-2912
US

IV. Provider business mailing address

PO BOX 542
SANTA CRUZ CA
95061-0542
US

V. Phone/Fax

Practice location:
  • Phone: 808-427-3500
  • Fax:
Mailing address:
  • Phone: 831-427-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA207065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-22725
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: