Provider Demographics
NPI:1225091101
Name:CHINN, HANK JONATHAN JR (MPT)
Entity Type:Individual
Prefix:MR
First Name:HANK
Middle Name:JONATHAN
Last Name:CHINN
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3717
Mailing Address - Country:US
Mailing Address - Phone:562-428-3556
Mailing Address - Fax:562-428-3621
Practice Address - Street 1:4010 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2374
Practice Address - Country:US
Practice Address - Phone:562-428-3556
Practice Address - Fax:562-428-3621
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT23647AOtherPPIN
CAZZZ08588ZOtherBLUE SHIELD
CA5208580001Medicare NSC
CAQ12304Medicare UPIN