Provider Demographics
NPI:1114627981
Name:LUO, LIN
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 JOSEPH LN
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-2123
Mailing Address - Country:US
Mailing Address - Phone:209-918-5868
Mailing Address - Fax:
Practice Address - Street 1:990 W FREMONT AVE STE N
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3065
Practice Address - Country:US
Practice Address - Phone:209-918-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist