Healthcare Provider Details

I. General information

NPI: 1437669561
Provider Name (Legal Business Name): LIN CHIROPRACTIC PROFESSIONALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14785 JEFFREY RD STE 102
IRVINE CA
92618-0409
US

IV. Provider business mailing address

14785 JEFFREY RD STE 102
IRVINE CA
92618-0409
US

V. Phone/Fax

Practice location:
  • Phone: 949-857-2388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number33035
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16303
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11395
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number29229
License Number StateCA

VIII. Authorized Official

Name: DR. JONATHAN LIN
Title or Position: PRESIDENT
Credential: DC, L.AC.
Phone: 714-767-6178