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NPI 1891794152

NPI 1891794152 : STEFAN J CHIN MD : DALY CITY, CA

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General NPI Number Information
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    NPI Number           |    1891794152
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    Entity Type          |    Individual 
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    Provider Name        |    STEFAN J CHIN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/19/2005
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    Last Update Date     |    09/10/2014
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Provider Practice Location Address
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    Address Line         |    1850 SULLIVAN AVE #520
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    City                 |    DALY CITY
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    State                |    CA
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    Zip                  |    94015-2221
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    Country              |    US
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    Telephone            |    650-756-5000
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    Fax                  |    650-756-5903
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Provider Business Mailing Address
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    Address Line         |    1850 SULLIVAN AVE #520
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    City                 |    DALY CITY
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    State                |    CA
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    Zip                  |    94015-2221
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    Country              |    US
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    Telephone            |    650-756-5000
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    Fax                  |    650-756-5903
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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        |    207RG0100X
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    Taxonomy Name        |    Gastroenterology Physician
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    License Number       |    G83120
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    License Number State |    CA
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