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General NPI Number Information
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NPI Number | 1073076709
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Entity Type | Individual
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Provider Name | CHARLES LIN
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Gender | Male
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 181 W MEADOW DR STE 400
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City | VAIL
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State | CO
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Zip | 81657-5058
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Country | US
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Telephone | 970-476-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 12123 CANDY LN
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City | SARATOGA
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State | CA
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Zip | 95070-3307
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Country | US
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Telephone | 408-605-5718
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | DR.0074681
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License Number State | CO
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