MEDICARE: ALICE HUAICHING LIN O.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
1	152W00000X	Optometrist	OPT 11009T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5702933	OTHER	CA	MEDI-CAL PIN #

General Provider Information

NPI Number	:	1770636896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE HUAICHING LIN O.D

Provider Business Mailing Address
First Line	:	39055 CEDAR BLVD STE 133
Second Line	:
City	:	NEWARK
State	:	CA
Zip	:	94560-5009
Country	:	US
Telephone Number	:	510-795-0888
Fax Number	:	510-795-0809

Provider Business Practice Location Address
First Line	:	39055 CEDAR BLVD STE 133
Second Line	:
City	:	NEWARK
State	:	CA
Zip	:	94560-5009
Country	:	US
Telephone Number	:	510-795-0888
Fax Number	:	510-795-0809

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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