Provider Demographics
NPI:1891793451
Name:HO, SAM CHIN (DC)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:CHIN
Last Name:HO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31840 VIA SANTA ELENA
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8612
Mailing Address - Country:US
Mailing Address - Phone:951-264-4811
Mailing Address - Fax:
Practice Address - Street 1:39755 DATE ST
Practice Address - Street 2:STE 207
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2008
Practice Address - Country:US
Practice Address - Phone:951-698-7977
Practice Address - Fax:951-698-1696
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor