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General NPI Number Information
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NPI Number | 1447271697
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Entity Type | Organization
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Legal Business Name | SAMUEL CHIN MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 3751 KATELLA AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3101
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Country | US
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Telephone | 562-799-3234
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Fax |
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Provider Business Mailing Address
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Address Line | 27742 AGATE CANYON DR
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-4057
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Country | US
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Telephone | 909-278-8831
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SAMUEL CHIN
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Credential | M.D.
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Telephone | 909-278-8831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | A77228
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License Number State | CA
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