Healthcare Provider Details

I. General information

NPI: 1578527255
Provider Name (Legal Business Name): CORINA NGO CHIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FOONG NGO CHIN

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 05/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19042 SOLEDAD CANYON RD
SANTA CLARITA CA
91351-3362
US

IV. Provider business mailing address

19042 SOLEDAD CANYON RD
SANTA CLARITA CA
91351-3362
US

V. Phone/Fax

Practice location:
  • Phone: 661-251-6300
  • Fax: 661-251-6303
Mailing address:
  • Phone: 661-251-6300
  • Fax: 661-251-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA89287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: