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General NPI Number Information
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NPI Number | 1841216892
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Entity Type | Individual
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Provider Name | JONATHAN LUM CHIN MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 2350 COUNTRY HILLS DR STE A
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City | ANTIOCH
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State | CA
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Zip | 94509-7436
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Country | US
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Telephone | 925-779-9097
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Fax | 925-779-0801
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Provider Business Mailing Address
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Address Line | 2350 COUNTRY HILLS DR STE A
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City | ANTIOCH
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State | CA
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Zip | 94509-7436
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Country | US
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Telephone | 925-779-9097
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Fax | 925-779-0801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A77873
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License Number State | CA
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