Healthcare Provider Details

I. General information

NPI: 1184893935
Provider Name (Legal Business Name): LESLIE ALAN LIN M D, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2531
US

IV. Provider business mailing address

17150 NEWHOPE ST SUITE 507
FOUNTAIN VALLEY CA
92708-4250
US

V. Phone/Fax

Practice location:
  • Phone: 714-437-7400
  • Fax: 714-437-7410
Mailing address:
  • Phone: 714-437-7400
  • Fax: 714-437-7410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE A LIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-437-7400