Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT 9785T | CA |
NPI | 1003969254 |
---|---|
Provider Name | Dr. Daniel Chin |
First Address | Alameda, CA 94501 |
Second Address | Alameda, CA 94501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SD0097850 | (05) | CA |
U25822 | (02) | CA |