Healthcare Provider Details

I. General information

NPI: 1083343370
Provider Name (Legal Business Name): BRIAN LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BERRY ST LBBY 2
SAN FRANCISCO CA
94107-5705
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-6420
  • Fax:
Mailing address:
  • Phone: 301-699-7707
  • Fax: 301-779-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMTL500001839
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA208558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: