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General NPI Number Information
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NPI Number | 1437194917
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA ENDOCRINE CENTER INCOPORATED
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 207 S SANTA ANITA ST STE. P-20
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1146
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Country | US
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Telephone | 626-585-8911
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Fax | 626-585-8914
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Provider Business Mailing Address
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Address Line | 207 S SANTA ANITA ST STE. P-20
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1146
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Country | US
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Telephone | 626-585-8911
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Fax | 626-585-8914
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL W LIN
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Credential | MD
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Telephone | 626-585-8911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A60921
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License Number State | CA
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