Provider Demographics
NPI:1841216892
Name:CHIN, JONATHAN LUM (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LUM
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2350 COUNTRY HILLS DR STE A
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-7436
Mailing Address - Country:US
Mailing Address - Phone:925-779-9097
Mailing Address - Fax:925-779-0801
Practice Address - Street 1:2350 COUNTRY HILLS DR STE A
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-7436
Practice Address - Country:US
Practice Address - Phone:925-779-9097
Practice Address - Fax:925-779-0801
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2022-03-29
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Provider Licenses
StateLicense IDTaxonomies
CAA77873208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology