Provider Demographics
NPI:1275901795
Name:LIN, ROBIN (RPH)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2481
Mailing Address - Country:US
Mailing Address - Phone:909-464-0063
Mailing Address - Fax:909-270-4201
Practice Address - Street 1:5555 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2481
Practice Address - Country:US
Practice Address - Phone:909-464-0063
Practice Address - Fax:909-270-4201
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2017-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH73317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist