Healthcare Provider Details

I. General information

NPI: 1992766000
Provider Name (Legal Business Name): UCLA ORAL PATHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

10833 LE CONTE AVE. CHS 53-058B
LOS ANGELES CA
90095-1668
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-6848
  • Fax:
Mailing address:
  • Phone: 310-206-4731
  • Fax: 805-578-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. YI-LING LIN
Title or Position: ASSOC. PROFESSOR
Credential: DDS
Phone: 310-206-4731