Healthcare Provider Details
I. General information
NPI: 1265403802
Provider Name (Legal Business Name): VICTOR LIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/31/2006
Last Update Date: 05/16/2024
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7700 ARLINGTON BLVD
FALLS CHURCH VA
22042-2929
US
IV. Provider business mailing address
7700 ARLINGTON BLVD
FALLS CHURCH VA
22042-2929
US
V. Phone/Fax
- Phone: 703-681-7349
- Fax:
- Phone: 703-681-7349
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | A90477 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: