Provider Demographics
NPI:1306813183
Name:LIN, JIIN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JIIN
Middle Name:T
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JIIN-TARNG
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:39271 MISSION BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3039
Mailing Address - Country:US
Mailing Address - Phone:510-792-7875
Mailing Address - Fax:510-792-7885
Practice Address - Street 1:39271 MISSION BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3039
Practice Address - Country:US
Practice Address - Phone:510-792-7875
Practice Address - Fax:510-792-7885
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine