Provider Demographics
NPI:1992017636
Name:MAI, CHINH (MD)
Entity Type:Individual
Prefix:
First Name:CHINH
Middle Name:
Last Name:MAI
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 1:8251 WESTMINSTER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3370
Mailing Address - Country:US
Mailing Address - Phone:832-677-7437
Mailing Address - Fax:855-227-7512
Practice Address - Street 1:8251 WESTMINSTER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3370
Practice Address - Country:US
Practice Address - Phone:714-839-5898
Practice Address - Fax:855-227-7512
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126013208M00000X, 207R00000X
CA07051659282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA126013OtherMEDICAL LICENSE