Provider Demographics
NPI:1477619120
Name:CHINN, STEVEN DOUGLAS (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:CHINN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 MIRANDA AVE
Mailing Address - Street 2:QUALITY MANAGEMENT
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1207
Mailing Address - Country:US
Mailing Address - Phone:650-849-0236
Mailing Address - Fax:650-849-0117
Practice Address - Street 1:423 BROADWAY
Practice Address - Street 2:#626
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1905
Practice Address - Country:US
Practice Address - Phone:650-759-3938
Practice Address - Fax:650-651-1617
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT164213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist