Healthcare Provider Details

I. General information

NPI: 1326570086
Provider Name (Legal Business Name): ANDREW LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9452 MEDICAL CENTER DR
LA JOLLA CA
92037-7411
US

IV. Provider business mailing address

9452 MEDICAL CENTER DRIVE
LA JOLLA CA
92037-7411
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-6268
  • Fax:
Mailing address:
  • Phone: 317-674-5503
  • Fax: 858-657-1828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA159000
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA159000
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: