Provider Demographics
NPI:1285661819
Name:LIN, MICHAEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:LIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:207 S SANTA ANITA AVE
Mailing Address - Street 2:STE. P-20
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1138
Mailing Address - Country:US
Mailing Address - Phone:626-585-8911
Mailing Address - Fax:626-585-8914
Practice Address - Street 1:207 S SANTA ANITA AVE
Practice Address - Street 2:STE. P-20
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1138
Practice Address - Country:US
Practice Address - Phone:626-585-8911
Practice Address - Fax:626-585-8914
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA60921207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
G73951Medicare UPIN
A60921Medicare ID - Type Unspecified