Provider Demographics
NPI:1952324121
Name:CHIN, HUBERT (MD)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PALOMINO LANE
Mailing Address - Street 2:# 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4894
Mailing Address - Country:US
Mailing Address - Phone:702-759-8600
Mailing Address - Fax:702-384-1815
Practice Address - Street 1:2020 PALOMINO LANE
Practice Address - Street 2:# 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4894
Practice Address - Country:US
Practice Address - Phone:702-759-8600
Practice Address - Fax:702-384-1815
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA795772085R0202X
NV140292085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952324121Medicaid
OK200468110AMedicaid
AZ639088Medicaid
NV1952324121Medicaid
CAP01285911OtherRR MEDICARE DRS
CAFX696RMedicare PIN
CAP01285911OtherRR MEDICARE DRS
H72819Medicare UPIN
CA1952324121Medicaid
NVFI535ZMedicare PIN
CAFX696SMedicare PIN