Provider Demographics
NPI:1215178173
Name:LIN, HO MU (LAC)
Entity Type:Individual
Prefix:
First Name:HO MU
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W LAS TUNAS DR
Mailing Address - Street 2:#102
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1386
Mailing Address - Country:US
Mailing Address - Phone:626-286-8698
Mailing Address - Fax:
Practice Address - Street 1:113 W LAS TUNAS DR
Practice Address - Street 2:#102
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1386
Practice Address - Country:US
Practice Address - Phone:626-286-8698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13037171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD6092014OtherCALIFORNIS DRIVER LICENSE