MEDICARE: JEANNIE CHANG 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A78339	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	:	1306870050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE CHANG LIN MD

Provider Business Mailing Address
First Line	:	2707 E VALLEY BLVD
Second Line	:	SUITE 109
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3195
Country	:	US
Telephone Number	:	626-956-8024
Fax Number	:	310-956-8010

Provider Business Practice Location Address
First Line	:	2707 E VALLEY BLVD
Second Line	:	SUITE 109
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3195
Country	:	US
Telephone Number	:	626-956-8024
Fax Number	:	310-956-8010

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/15/2009

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