Healthcare Provider Details

I. General information

NPI: 1245382118
Provider Name (Legal Business Name): BIANCA CHIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

PO BOX 964
CINCINNATI OH
45201-0964
US

V. Phone/Fax

Practice location:
  • Phone: 888-372-2446
  • Fax: 888-372-2446
Mailing address:
  • Phone: 888-372-2446
  • Fax: 888-372-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number31-126498
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: