MEDICARE: DR. EDWARD LIN DPT

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	225100000X	Physical Therapist	293046	CA

General Provider Information

NPI Number	:	1821519588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD LIN DPT

Provider Business Mailing Address
First Line	:	2380 CARDINAL DR APT 16
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4105
Country	:	US
Telephone Number	:	805-427-1984
Fax Number	:

Provider Business Practice Location Address
First Line	:	2380 CARDINAL DR APT 16
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4105
Country	:	US
Telephone Number	:	805-427-1984
Fax Number	:

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

Provider Enumeration Date	:	07/03/2017
Last Update Date	:	07/21/2022

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Directions to “ DR. EDWARD LIN DPT” Practice Location

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