MEDICARE: ETHAN WIN THEIN 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	208M00000X	Hospitalist Physician	A164328	CA
2	208M00000X	Hospitalist Physician	C1-0025351	DE
3	207Q00000X	Family Medicine Physician	MD.47106	AL
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1255871711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHAN WIN THEIN LIN MD

Provider Business Mailing Address
First Line	:	1100 WILSHIRE BLVD APT 2507
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1963
Country	:	US
Telephone Number	:	510-612-5529
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 WILSHIRE BLVD APT 2507
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1963
Country	:	US
Telephone Number	:	510-612-5529
Fax Number	:

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

Provider Enumeration Date	:	03/03/2017
Last Update Date	:	10/20/2025

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