MEDICARE: DR. ALAN LINCOLN PH.D.

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	103TC0700X	Clinical Psychologist	PSY 7244	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	:	1104819119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN LINCOLN PH.D.

Provider Business Mailing Address
First Line	:	10065 OLD GROVE RD.
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-1664
Country	:	US
Telephone Number	:	858-444-8823
Fax Number	:	858-444-8827

Provider Business Practice Location Address
First Line	:	10065 OLD GROVE RD.
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-1664
Country	:	US
Telephone Number	:	858-444-8823
Fax Number	:	858-444-8827

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	01/22/2009

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