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General NPI Number Information
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NPI Number | 1124169636
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Entity Type | Individual
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Provider Name | KEN C LIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 1488
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City | HONOLULU
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State | HI
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Zip | 96814-4471
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Country | US
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Telephone | 808-946-7889
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Fax | 808-946-7880
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD STE 1488
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City | HONOLULU
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State | HI
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Zip | 96814-4471
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Country | US
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Telephone | 808-946-7889
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Fax | 808-946-7880
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD10751
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License Number State | HI
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