Provider Demographics
NPI:1295440493
Name:CHIN, AUSTIN YUNG TZEN
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:YUNG TZEN
Last Name:CHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 LONGSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2100
Mailing Address - Country:US
Mailing Address - Phone:702-526-1155
Mailing Address - Fax:
Practice Address - Street 1:5125 LONGSTONE WAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2100
Practice Address - Country:US
Practice Address - Phone:702-526-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program