Provider Demographics
NPI:1114057254
Name:LIN, CHI-WHEI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHI-WHEI
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3107
Mailing Address - Country:US
Mailing Address - Phone:949-716-4555
Mailing Address - Fax:949-716-4437
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 310
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3107
Practice Address - Country:US
Practice Address - Phone:949-716-4555
Practice Address - Fax:949-716-4437
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA55435P47Medicaid
CAG59200Medicare UPIN
CAA55435P47Medicaid