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NPI Code Detail

MEDICARE: BRYAN LIN

MEDICARE: BRYAN 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639033210
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN LIN
Provider Business Mailing Address
First Line : 3045 GROVE WAY
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94546-6703
Country : US
Telephone Number : 510-688-8166
Fax Number :
Provider Business Practice Location Address
First Line : 3045 GROVE WAY
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94546-6703
Country : US
Telephone Number : 510-688-8166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ BRYAN LIN ” Practice Location

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