Healthcare Provider Details

I. General information

NPI: 1194350736
Provider Name (Legal Business Name): S LIN MEDICAL CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49256 ESCALANTE ST
INDIO CA
92201-8850
US

IV. Provider business mailing address

49256 ESCALANTE ST
INDIO CA
92201-8850
US

V. Phone/Fax

Practice location:
  • Phone: 760-863-1592
  • Fax: 760-485-1561
Mailing address:
  • Phone: 760-863-1592
  • Fax: 760-485-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAM Y LIN
Title or Position: PRESIDENT
Credential: MD
Phone: 760-534-2707