MEDICARE: DR. SHOU I LIN MD

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
1	208000000X	Pediatrics Physician	A33667	CA

General Provider Information

NPI Number	:	1114963873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHOU I LIN MD

Provider Business Mailing Address
First Line	:	75 W MARCH LANE
Second Line	:	#G
City	:	STOCKTON
State	:	CA
Zip	:	95207-5729
Country	:	US
Telephone Number	:	209-951-6072
Fax Number	:	209-951-0181

Provider Business Practice Location Address
First Line	:	75 W MARCH LANE
Second Line	:	#G
City	:	STOCKTON
State	:	CA
Zip	:	95207-5729
Country	:	US
Telephone Number	:	209-951-6072
Fax Number	:	209-951-0181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	07/08/2007

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