MEDICARE: KATHERINE JOAN CHIN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant		CA

General Provider Information

NPI Number	:	1053654640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JOAN CHIN PA

Provider Business Mailing Address
First Line	:	3280 E FOOTHILL BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3103
Country	:	US
Telephone Number	:	323-881-9620
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 S ATLANTIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-3211
Country	:	US
Telephone Number	:	323-881-9620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2013
Last Update Date	:	10/27/2021

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Directions to “ KATHERINE JOAN CHIN PA” Practice Location

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