MEDICARE: MITCHELL 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	207L00000X	Anesthesiology Physician	Q9964	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	050086413	OTHER	CA	RR MEDICARE

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
2	00A796950303	OTHER	CA	CALOPTIMA
3	00A796950	OTHER	CA	BLUE SHIELD OF CA

General Provider Information

NPI Number	:	1093751216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL LIN MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-645-0355
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD DALLAS
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-0001
Country	:	US
Telephone Number	:	214-645-0355
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	09/29/2016

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Directions to “ MITCHELL LIN MD” Practice Location

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