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General NPI Number Information
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NPI Number | 1477733467
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Entity Type | Organization
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Legal Business Name | VICTORINO D CHIN MD (DBA HOLY FAMILY HEALTH CLINIC)
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 1110 2ND ST
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City | MOUNDSVILLE
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State | WV
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Zip | 26041-1451
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Country | US
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Telephone | 304-845-1460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX N
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City | MOUNDSVILLE
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State | WV
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Zip | 26041-0964
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Country | US
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Telephone | 304-845-1460
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | VICTORINO D. CHIN
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Credential | M.D.
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Telephone | 304-845-1460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10205
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35035509C
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License Number State | OH
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