Provider Demographics
NPI:1346306164
Name:LIN RADIOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:LIN RADIOLOGICAL ASSOCIATES
Other - Org Name:VASCULAR INSTITUTE OF PASADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:310-600-3430
Mailing Address - Street 1:506 W VALLEY BLVD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3731
Mailing Address - Country:US
Mailing Address - Phone:626-593-9393
Mailing Address - Fax:626-593-9392
Practice Address - Street 1:506 W VALLEY BLVD # 300
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3731
Practice Address - Country:US
Practice Address - Phone:626-593-9393
Practice Address - Fax:626-593-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA781492085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19529OtherPTAN