MEDICARE: YI LIN MEDICAL CENTER

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	171100000X	Acupuncturist	655	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1194898239	OTHER	NM	NPI PROVIDER NUMBER

General Provider Information

NPI Number	:	1285821173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YI LIN MEDICAL CENTER

Provider Business Mailing Address
First Line	:	4775 INDIAN SCHOOL RD NE
Second Line	:	SUITE 100
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3973
Country	:	US
Telephone Number	:	505-888-6700
Fax Number	:	505-888-6701

Provider Business Practice Location Address
First Line	:	4775 INDIAN SCHOOL RD NE
Second Line	:	SUITE 100
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3973
Country	:	US
Telephone Number	:	505-888-6700
Fax Number	:	505-888-6701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. PING CHEN
Credential	:	DOM, MD
Telephone Number	:	505-888-6700

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	09/25/2007

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Directions to “YI LIN MEDICAL CENTER ” Practice Location

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