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NPI Code Detail

MEDICARE: DR. INIL LISA LIN M.D.

MEDICARE: DR. INIL LISA 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
1207Q00000XFamily Medicine PhysicianA84233CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WA84233AOTHERCAPPIN
2W11614OTHERCAGROUP ID

General Provider Information

NPI Number : 1942395983
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. INIL LISA LIN M.D.
Provider Business Mailing Address
First Line : 6261 STANTON AVE
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-2436
Country : US
Telephone Number : 714-739-4325
Fax Number : 714-452-1679
Provider Business Practice Location Address
First Line : 6261 STANTON AVE
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-2436
Country : US
Telephone Number : 714-739-4325
Fax Number : 714-452-1679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 12/28/2010

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