MEDICARE: JIE LIN

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	363LF0000X	Family Nurse Practitioner	F11250157	CA

General Provider Information

NPI Number	:	1396607727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIE LIN

Provider Business Mailing Address
First Line	:	510 N 13TH AVE STE 101
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4973
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3062 E OAK KNOLL LOOP
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-3872
Country	:	US
Telephone Number	:	626-377-6018
Fax Number	:

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

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	03/04/2026

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Directions to “ JIE LIN ” Practice Location

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