Provider Demographics
NPI:1093156150
Name:LIN, KAREN H (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:LIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 WISTERIA LN
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4958
Mailing Address - Country:US
Mailing Address - Phone:626-429-4847
Mailing Address - Fax:
Practice Address - Street 1:2934 WISTERIA LN
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4958
Practice Address - Country:US
Practice Address - Phone:626-429-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12328152W00000X
CA14752152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist