Healthcare Provider Details

I. General information

NPI: 1770824633
Provider Name (Legal Business Name): JANE H CHIN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST. KAISER HOSPITAL OP PEDIATRIC PHARMACY
WALNUT CREEK CA
94596
US

IV. Provider business mailing address

1425 S MAIN ST KAISER HOSPITAL OP PEDIATRIC PHARMACY
WALNUT CREEK CA
94596
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-5969
  • Fax: 925-295-5437
Mailing address:
  • Phone: 925-295-5969
  • Fax: 925-295-5437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: