Healthcare Provider Details

I. General information

NPI: 1801546973
Provider Name (Legal Business Name): JEFFREY H LIN MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

3701 OVERLAND AVE APT J184
LOS ANGELES CA
90034-6374
US

V. Phone/Fax

Practice location:
  • Phone: 267-648-3417
  • Fax:
Mailing address:
  • Phone: 310-825-6301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA201183
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: