Provider Demographics
NPI:1073168027
Name:MICHELLE LIN D O PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:MICHELLE LIN D O PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:MY FAMILY DOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:I
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-209-3590
Mailing Address - Street 1:3227 E WARM SPRINGS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3180
Mailing Address - Country:US
Mailing Address - Phone:702-209-3590
Mailing Address - Fax:949-404-8363
Practice Address - Street 1:3227 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3180
Practice Address - Country:US
Practice Address - Phone:702-209-3590
Practice Address - Fax:949-404-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty