1457668436 NPI number — DAVID LIN L.AC

Table of content: DAVID LIN L.AC (NPI 1457668436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457668436 NPI number — DAVID LIN L.AC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIN
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.AC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIN
Provider Other First Name:
CHIA
Provider Other Middle Name:
WEI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457668436
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10050 GARVEY AVE STE 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL MONTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91733-2089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-582-5856
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10050 GARVEY AVE STE 103
Provider Second Line Business Practice Location Address:
#103
Provider Business Practice Location Address City Name:
EL MONTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91733-2089
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-780-5597
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC13548 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)