Individual provider Active NPI

Catherine Anne Chin, MD

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1376643528
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G64349 Issued in CA
Practice address
1030 International Blvd
Oakland, CA 94601
Phone
(510) 238-5400
Fax
(510) 238-5437
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G64349 CA Primary

Addresses

Primary practice location

1030 International Blvd
Oakland, CA 94601

Mailing address

1515 Fruitvale Ave
Oakland, CA 94601
Phone (510) 535-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000583 CA Practitioner - Pediatric Medicine 1254469497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, San Francisco School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

1030 International Blvd
Oakland, CA 94606-3730
Phone (510) 238-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza, Inc. CurrentSince Mar 14, 2010 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
La Clinica de la Raza Inc CurrentSince Mar 14, 2010 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1030 International Blvd
Oakland, CA 94606
Phone (510) 238-5400

1515 Fruitvale Ave
Oakland, CA 94601
Phone (510) 535-6300

1700 28th Ave
Oakland, CA 94601
Phone (510) 535-6440

2021 Main St
Oakley, CA 94561
Phone (925) 776-8200

Interoperability endpoints

  • Direct secure messaging: cchin306374@direct.ochin.org

Organizations & group practices 5

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1376643528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-238-5400",
            "fax_number": "510-238-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "CATHERINE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G64349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.