MEDICARE: DR. JOHN 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	A82618	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A826180	OTHER	CA	BLUE SHIELD
2	A82618	OTHER	CA	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	00A826180	OTHER	CA	CALOPTIMA

General Provider Information

NPI Number	:	1972558138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LIN M.D.

Provider Business Mailing Address
First Line	:	27055 ISLAND RD
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-1607
Country	:	US
Telephone Number	:	310-623-0020
Fax Number	:	661-670-0393

Provider Business Practice Location Address
First Line	:	27055 ISLAND RD
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-1607
Country	:	US
Telephone Number	:	310-623-0020
Fax Number	:	661-670-0393

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/04/2011

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