Provider Demographics
NPI:1013140219
Name:CHIN, ERICA H (RN, NP, MS)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:H
Last Name:CHIN
Suffix:
Gender:F
Credentials:RN, NP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:626-775-3514
Mailing Address - Fax:626-218-5310
Practice Address - Street 1:1500 EAST DUARTE RD
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3000
Practice Address - Country:US
Practice Address - Phone:626-256-4673
Practice Address - Fax:626-471-7155
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19314363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health