Provider Demographics
NPI:1144394339
Name:LIN, EDWIN CHENG MEAN (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:CHENG MEAN
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 1:4209 ST CLAUDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-5338
Mailing Address - Country:US
Mailing Address - Phone:504-944-0144
Mailing Address - Fax:504-944-3666
Practice Address - Street 1:4209 ST CLAUDE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-5338
Practice Address - Country:US
Practice Address - Phone:504-944-0144
Practice Address - Fax:504-944-3666
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD014384208000000X
CAA40279208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1300195Medicaid