Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 19314 | CA |
N | 363LW0102X | Nurse Practitioner - Women's Health | 19314 | CA |
NPI | 1013140219 |
---|---|
Provider Name | Mrs. Erica H Chin |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2009 |
Last Update Date | 25/11/2020 |