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NPI Code Detail

MEDICARE: ANDREW LIN D.O.

MEDICARE: ANDREW LIN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist PhysicianOS22478FL
22084N0400XNeurology PhysicianOS22478FL
32084N0400XNeurology Physician20A17256CA
42084N0400XNeurology Physician2025036730MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033506175
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW LIN D.O.
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11215 METRO PKWY STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-1206
Country : US
Telephone Number : 239-208-2212
Fax Number : 239-208-3994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2015
Last Update Date : 12/04/2025

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