Provider Demographics
NPI:1639833643
Name:CHIN, GRACE SAEROM (PHARMD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:SAEROM
Last Name:CHIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:SAEROM
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4400 E BAILS PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 E 19TH AVE STE 5050
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1200
Practice Address - Country:US
Practice Address - Phone:720-754-2155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00223351835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist