Provider Demographics
NPI:1003133885
Name:LINCOLN MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LINCOLN MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-226-2611
Mailing Address - Street 1:1530 3RD ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-1562
Mailing Address - Country:US
Mailing Address - Phone:916-645-3388
Mailing Address - Fax:
Practice Address - Street 1:1530 3RD ST
Practice Address - Street 2:SUITE 106
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-1562
Practice Address - Country:US
Practice Address - Phone:916-645-3388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A8777OtherCA LICENSE NO