Provider Demographics
NPI:1285944264
Name:CHIN, ALAN (RPH)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14425 MORENO BEACH DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-8702
Mailing Address - Country:US
Mailing Address - Phone:951-242-7471
Mailing Address - Fax:951-924-4895
Practice Address - Street 1:14425 MORENO BEACH DR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-8702
Practice Address - Country:US
Practice Address - Phone:951-242-7471
Practice Address - Fax:951-924-4895
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARX37052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist