MEDICARE: DR. GEORGE ING-HSIANG LIN D.D.S.

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	1223G0001X	General Practice Dentistry	35139	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B35139-01	OTHER	CA	MEDI-CAL
2	B35139-01	OTHER	CA	DELTA STATE GOV. PROGRAM

General Provider Information

NPI Number	:	1104910843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ING-HSIANG LIN D.D.S.

Provider Business Mailing Address
First Line	:	16026 GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:	626-968-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	16026 GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:	626-968-7777
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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