Healthcare Provider Details

I. General information

NPI: 1992017636
Provider Name (Legal Business Name): CHINH MAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2010
Last Update Date: 04/01/2022
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8251 WESTMINSTER BLVD STE 110
WESTMINSTER CA
92683-3370
US

IV. Provider business mailing address

8251 WESTMINSTER BLVD STE 110
WESTMINSTER CA
92683-3370
US

V. Phone/Fax

Practice location:
  • Phone: 714-839-5898
  • Fax: 855-227-7512
Mailing address:
  • Phone: 832-677-7437
  • Fax: 855-227-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number07051659
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA126013
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA126013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: