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General NPI Number Information
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NPI Number | 1730257338
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Entity Type | Organization
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Legal Business Name | WING CHIN, M.D.
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 20055 LAKE CHABOT RD SUITE 300
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5331
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Country | US
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Telephone | 510-886-2311
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Fax | 510-886-9374
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Provider Business Mailing Address
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Address Line | P. O. BOX 1145
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City | LAFAYETTE
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State | CA
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Zip | 94549-1145
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Country | US
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Telephone | 510-886-2311
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Fax | 510-886-9374
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Authorized Official
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Title or Position | M.D.
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Name | DR. WING CHIN
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Credential | M.D.
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Telephone | 510-886-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C28239
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License Number State | CA
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