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NPI Code Detail

MEDICARE: WENYUN DIANE LIN OD.

MEDICARE: WENYUN DIANE LIN OD.
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
1152W00000XOptometrist11369CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
211369OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1093746414
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENYUN DIANE LIN OD.
Provider Business Mailing Address
First Line : PO BOX 9602
Second Line :
City : MISSION HILLS
State : CA
Zip : 91346-9602
Country : US
Telephone Number : 818-837-5637
Fax Number : 818-837-5589
Provider Business Practice Location Address
First Line : 17909 SOLEDAD CANYON RD
Second Line :
City : CANYON COUNTRY
State : CA
Zip : 91387-3210
Country : US
Telephone Number : 661-250-5220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 09/25/2012

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