Provider Demographics
NPI:1730236860
Name:CHIN, BING K (LAC)
Entity type:Individual
Prefix:
First Name:BING
Middle Name:K
Last Name:CHIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 10TH ST
Mailing Address - Street 2:#113
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4269
Mailing Address - Country:US
Mailing Address - Phone:510-839-7439
Mailing Address - Fax:
Practice Address - Street 1:320 10TH ST
Practice Address - Street 2:#113
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4269
Practice Address - Country:US
Practice Address - Phone:510-839-7439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5560171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0055600Medicaid