MEDICARE: DR. TED S 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	207V00000X	Obstetrics & Gynecology Physician	A32918	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1245389881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TED S LIN MD

Provider Business Mailing Address
First Line	:	2190 LYNN RD
Second Line	:	SUITE 240
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1980
Country	:	US
Telephone Number	:	805-496-9976
Fax Number	:	805-496-9970

Provider Business Practice Location Address
First Line	:	2190 LYNN RD
Second Line	:	240
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1980
Country	:	US
Telephone Number	:	805-496-9976
Fax Number	:	805-496-9970

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	11/23/2010

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Directions to “ DR. TED S LIN MD” Practice Location

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