MEDICARE: DR. STEPHEN ANDREW LIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G74809	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073612735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ANDREW LIN MD

Provider Business Mailing Address
First Line	:	36 WEST YOKUTS AVE
Second Line	:	SUITE 1
City	:	STOCKTON
State	:	CA
Zip	:	95207-5713
Country	:	US
Telephone Number	:	209-952-3700
Fax Number	:	209-478-3302

Provider Business Practice Location Address
First Line	:	36 WEST YOKUTS AVE
Second Line	:	SUITE 1
City	:	STOCKTON
State	:	CA
Zip	:	95207-5713
Country	:	US
Telephone Number	:	209-952-3700
Fax Number	:	209-478-3302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/05/2024

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