MEDICARE: HAROLD M LIN MD A MEDICAL CORPORATION

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1326158635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD M LIN MD A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	3791 KATELLA AVE
Second Line	:	SUITE105
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2000
Country	:	US
Telephone Number	:	562-594-6693
Fax Number	:	562-596-9703

Provider Business Practice Location Address
First Line	:	3791 KATELLA AVE
Second Line	:	SUITE105
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2000
Country	:	US
Telephone Number	:	562-594-6693
Fax Number	:	562-596-9703

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HAROLD M LIN
Credential	:	M.D.
Telephone Number	:	562-594-6693

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/29/2008

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