Provider Demographics
NPI:1083619100
Name:LIN, PAUL SC (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:SC
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:223 N 1ST AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7027
Mailing Address - Country:US
Mailing Address - Phone:626-698-7246
Mailing Address - Fax:626-447-1058
Practice Address - Street 1:960 E GREEN ST STE L-60
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2423
Practice Address - Country:US
Practice Address - Phone:626-793-3339
Practice Address - Fax:626-793-3118
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA51128207V00000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A51125DMedicaid
CAWA51128DMedicare ID - Type Unspecified
CA00A51125DMedicaid