Provider Demographics
NPI:1326292236
Name:X ELSIE LIN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:X ELSIE LIN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:XIANG-HONG
Authorized Official - Middle Name:ELSIE
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-288-0091
Mailing Address - Street 1:500 N GARFIELD AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1242
Mailing Address - Country:US
Mailing Address - Phone:626-288-0091
Mailing Address - Fax:626-288-0092
Practice Address - Street 1:500 N GARFIELD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-288-0091
Practice Address - Fax:626-288-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty