Provider Demographics
NPI:1104386077
Name:CHIN, AN GUO MICHAEL (DO, MPH, MS)
Entity Type:Individual
Prefix:
First Name:AN GUO MICHAEL
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:DO, MPH, MS
Other - Prefix:DR
Other - First Name:AN GUO MICHAEL
Other - Middle Name:
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1600 ARCH ST APT 709
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-2007
Mailing Address - Country:US
Mailing Address - Phone:215-796-8230
Mailing Address - Fax:
Practice Address - Street 1:327 BEACH 19TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4423
Practice Address - Country:US
Practice Address - Phone:718-869-7360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program