Healthcare Provider Details

I. General information

NPI: 1740864420
Provider Name (Legal Business Name): JAMES P LIN, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE STE 901
IRVINE CA
92618-3709
US

IV. Provider business mailing address

400 E RINCON ST STE 106
CORONA CA
92879-1389
US

V. Phone/Fax

Practice location:
  • Phone: 949-453-8600
  • Fax:
Mailing address:
  • Phone: 951-272-2221
  • Fax: 951-272-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMIE M HICKSON-KELTNER
Title or Position: OPERATIONS
Credential:
Phone: 951-272-2221