Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC 23637 | CA |
N | 225200000X | Physical Therapy Assistant | AT3326 | CA |
NPI | 1053409169 |
---|---|
Provider Name | Dr. Willard Chin |
First Address | San Francisco, CA 94124-3508 |
Second Address | South San Francisco, CA 94080-6407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 18/02/2016 |