Provider Demographics
NPI:1942720180
Name:CHIN, PAMELA H
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:CHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1826
Mailing Address - Country:US
Mailing Address - Phone:516-547-0127
Mailing Address - Fax:
Practice Address - Street 1:5620 W CORTARO FARMS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-9559
Practice Address - Country:US
Practice Address - Phone:520-872-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME164943207P00000X
WI3739207P00000X
IN01089244A207P00000X
CAA194693207P00000X
PAMD468337207P00000X
IL036.167787207P00000X
AZ60358207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine