1518963719 NPI number — DR. ANDREW YUH-FONG LIN M.D.

Table of content: DR. ANDREW YUH-FONG LIN M.D. (NPI 1518963719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518963719 NPI number — DR. ANDREW YUH-FONG LIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIN
Provider First Name:
ANDREW
Provider Middle Name:
YUH-FONG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
YUH FONG
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518963719
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/20/2006
NPI Reactivation Date:
04/05/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23600 TELO AVE
Provider Second Line Business Mailing Address:
STE 280
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90505-4037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-784-8000
Provider Business Mailing Address Fax Number:
310-784-8008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23600 TELO AVE
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90505-4037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-784-8000
Provider Business Practice Location Address Fax Number:
310-784-8008
Provider Enumeration Date:
06/22/2005

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: 207R00000X , with the licence number:  A37779 , 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)

  • Identifier: 00A377791 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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