Healthcare Provider Details

I. General information

NPI: 1053510099
Provider Name (Legal Business Name): ERIC LON LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 WATERWORKS WAY STE 240
IRVINE CA
92618-3175
US

IV. Provider business mailing address

113 WATERWORKS WAY STE 240
IRVINE CA
92618-3175
US

V. Phone/Fax

Practice location:
  • Phone: 949-340-9622
  • Fax: 949-528-3969
Mailing address:
  • Phone: 949-340-9622
  • Fax: 949-528-3969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA82296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: