Provider Demographics
NPI:1033267943
Name:LIN, KATHRYN CHANG (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CHANG
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:16465 SIERRA LAKES PKWY
Mailing Address - Street 2:STE 245
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1242
Mailing Address - Country:US
Mailing Address - Phone:909-829-7337
Mailing Address - Fax:909-829-1218
Practice Address - Street 1:16465 SIERRA LAKES PKWY
Practice Address - Street 2:STE 245
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1242
Practice Address - Country:US
Practice Address - Phone:909-829-7337
Practice Address - Fax:909-829-1218
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-11-26
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Provider Licenses
StateLicense IDTaxonomies
CAA86283207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine