=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699901397
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN DAVID LIN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2009
-----------------------------------------------------
Last Update Date | 10/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 289 W HUNTINGTON DR STE 103
-----------------------------------------------------
City | ARCADIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91007-3492
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-821-0707
-----------------------------------------------------
Fax | 626-821-0239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 90730
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91109-0730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-795-8051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | A107998
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207XS0106X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Hand Surgery Physician
-----------------------------------------------------
License Number | A107998
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------