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General NPI Number Information
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NPI Number | 1902916356
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Entity Type | Individual
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Provider Name | PHEBE C CHIN MSRD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-478-3711
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Fax | 310-268-4944
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Provider Business Mailing Address
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Address Line | 7711 W 82ND ST
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7914
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Country | US
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Telephone | 310-478-3711
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Fax | 310-268-4944
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 330109
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License Number State | IL
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