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General NPI Number Information
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NPI Number | 1093907578
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Entity Type | Organization
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Legal Business Name | SANTA MARIA WOMEN & CHILDREN MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 8401 LONG BEACH BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-2014
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Country | US
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Telephone | 562-822-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 17800 CASTLETON ST STE 578
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-5757
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Country | US
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Telephone | 626-308-0068
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Fax | 626-810-2189
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Authorized Official
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Title or Position | M.D. / OWNER
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Name | THOMAS H.T. LIN
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Credential | M.D.
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Telephone | 562-822-5750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A64211
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA15984
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A64211
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License Number State | CA
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