Healthcare Provider Details

I. General information

NPI: 1588248850
Provider Name (Legal Business Name): ISAAC TIAN-HANG LIN RD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 E WEST HWY
SILVER SPRING MD
20910-2602
US

IV. Provider business mailing address

4026 174TH CT NE
REDMOND WA
98052-5608
US

V. Phone/Fax

Practice location:
  • Phone: 301-587-2400
  • Fax:
Mailing address:
  • Phone: 206-335-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: