MEDICARE: JAMES T 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
1	174400000X	Specialist	G86229	CA

General Provider Information

NPI Number	:	1851406540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES T LIN M.D.

Provider Business Mailing Address
First Line	:	8021 LAGUNA BLVD
Second Line	:	SUITE 3
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7920
Country	:	US
Telephone Number	:	916-525-1559
Fax Number	:	916-525-1578

Provider Business Practice Location Address
First Line	:	8021 LAGUNA BLVD
Second Line	:	SUITE 3
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7920
Country	:	US
Telephone Number	:	916-525-1559
Fax Number	:	916-525-1578

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/09/2007

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