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General NPI Number Information
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NPI Number | 1386608065
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Entity Type | Individual
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Provider Name | MIMI CHEN WUN LIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39055 HASTINGS ST 106A
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City | FREMONT
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State | CA
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Zip | 94538-1518
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Country | US
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Telephone | 510-795-6990
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Fax | 510-795-6989
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Provider Business Mailing Address
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Address Line | 155 REQUA RD
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City | PIEDMONT
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State | CA
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Zip | 94611-4037
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Country | US
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Telephone | 510-644-6487
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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