Provider Demographics
NPI:1023299500
Name:CHINO MD LTD
Entity type:Organization
Organization Name:CHINO MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-233-8346
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 3-384A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6238
Mailing Address - Country:US
Mailing Address - Phone:702-233-8346
Mailing Address - Fax:702-369-1903
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:STE 560
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-233-8346
Practice Address - Fax:702-369-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV105160Medicare PIN