Active NPI
Charles Chin, D.D.S.
- Dentist
- Monterey Park, CA
National Provider Identifier
1043367147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29882
- Practice address
- 210 N Garfield Ave
305
Monterey Park, CA 91754-1746 - Phone
- (626) 573-3559
- Fax
- (626) 573-1247
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 29882 | CA | Primary |
Addresses
Primary practice location
210 N Garfield Ave
305
Monterey Park, CA 91754-1746
Mailing address
PO Box 6670
Alhambra, CA 91802-6670
Phone (626) 573-3559
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B2988201 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29882 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043367147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6670",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918026670",
"telephone_number": "626-573-3559",
"fax_number": "626-573-1247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N GARFIELD AVE",
"address_2": "305",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917541746",
"telephone_number": "626-573-3559",
"fax_number": "626-573-1247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "29882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "B2988201",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.