Individual provider Active NPI

Wing Chin, M.D.

  • Internal Medicine Physician
  • Castro Valley, CA
National Provider Identifier
1124052576
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C28239 Issued in CA
Practice address
20055 Lake Chabot Rd
#300
Castro Valley, CA 94546-5331
Phone
(510) 886-2311
Fax
(510) 886-9374
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C28239 CA Primary

Addresses

Primary practice location

20055 Lake Chabot Rd
#300
Castro Valley, CA 94546-5331

Mailing address

PO Box 1145
Lafayette, CA 94549-1145
Phone (510) 886-2311

Other identifiers 1

IdentifierTypeStateIssuer
C29239OtherCASTATE LICENCE #

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C28239CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wing Chin, M.D. Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124052576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1145",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945491145",
            "telephone_number": "510-886-2311",
            "fax_number": "510-886-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20055 LAKE CHABOT RD",
            "address_2": "#300",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465331",
            "telephone_number": "510-886-2311",
            "fax_number": "510-886-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "WING",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C28239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE #",
            "identifier": "C29239",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.