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NPI Code Detail

MEDICARE: JEANNETTE LIN M.D.

MEDICARE:   JEANNETTE  LIN  M.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
1207R00000XInternal Medicine PhysicianA95118CA
2207RC0000XCardiovascular Disease PhysicianA95118CA
3207RA0002XAdult Congenital Heart Disease PhysicianA95118CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568686491
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNETTE LIN M.D.
Provider Business Mailing Address
First Line : 101 THE CITY DR S
Second Line : STE 400, ZOT 4080
City : ORANGE
State : CA
Zip : 92868-3201
Country : US
Telephone Number : 714-456-6699
Fax Number :
Provider Business Practice Location Address
First Line : 101 THE CITY DR S
Second Line : STE 400, ZOT 4080
City : ORANGE
State : CA
Zip : 92868-3201
Country : US
Telephone Number : 714-456-6699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 02/10/2025

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