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NPI Code Detail

MEDICARE: DR. CHARLIE T LIN D.O.

MEDICARE: DR. CHARLIE T 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
1207Q00000XFamily Medicine Physician20A7717CA
2207Q00000XFamily Medicine Physician9424738-1204UT
3207Q00000XFamily Medicine PhysicianDO2835NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DO2835OTHERNVLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659314763
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLIE T LIN D.O.
Provider Business Mailing Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-216-3346
Fax Number :
Provider Business Practice Location Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-952-9171
Fax Number : 702-952-9136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 12/08/2025

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Directions to “ DR. CHARLIE T LIN D.O.” Practice Location

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