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General NPI Number Information
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NPI Number | 1043373889
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Entity Type | Individual
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Provider Name | BERTHA BIN-SAN LIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 99 MONTECILLO RD
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3308
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Country | US
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Telephone | 415-444-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 5 SILVER LACE CT
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1087
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Country | US
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Telephone | 415-407-5084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G85904
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | G85904
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | G85904
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License Number State | CA
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