Healthcare Provider Details

I. General information

NPI: 1326246653
Provider Name (Legal Business Name): SHIN KUAN LIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9542 ARTESIA BLVD
BELLFLOWER CA
90706-6511
US

IV. Provider business mailing address

5 HOLLAND STE 101
IRVINE CA
92618-2568
US

V. Phone/Fax

Practice location:
  • Phone: 562-925-8355
  • Fax: 562-565-2423
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA34420
License Number StateCA

VIII. Authorized Official

Name: SHIN KWAN LIN
Title or Position: PRESIDENT
Credential: MD
Phone: 949-588-2190