Provider Demographics
NPI:1114973294
Name:LIN, GENE WASHINGTON (MD)
Entity Type:Individual
Prefix:MR
First Name:GENE
Middle Name:WASHINGTON
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 1:9225 DOWDY DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6363
Mailing Address - Country:US
Mailing Address - Phone:858-578-6900
Mailing Address - Fax:858-578-6922
Practice Address - Street 1:9225 DOWDY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6363
Practice Address - Country:US
Practice Address - Phone:858-578-6900
Practice Address - Fax:858-578-6922
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA639442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H13214Medicare UPIN
CAWA63944AMedicare ID - Type Unspecified