Healthcare Provider Details

I. General information

NPI: 1295912277
Provider Name (Legal Business Name): ERINA MAY LIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 WILSHIRE BLVD SUITE # 202
LOS ANGELES CA
90401
US

IV. Provider business mailing address

1131 WILSHIRE BLVD SUITE # 202
LOS ANGELES CA
90401-2061
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-0867
  • Fax: 424-259-8571
Mailing address:
  • Phone: 310-825-0867
  • Fax: 424-259-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA77793
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License NumberA77793
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA77793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: