Provider Demographics
NPI:1396848230
Name:LIN, ROBERT KC (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KC
Last Name:LIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:888 N WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1353
Mailing Address - Country:US
Mailing Address - Phone:408-243-1528
Mailing Address - Fax:408-243-7366
Practice Address - Street 1:888 N WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1353
Practice Address - Country:US
Practice Address - Phone:408-243-1528
Practice Address - Fax:408-243-7366
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA43549208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29704Medicare UPIN
CA00A435490Medicare ID - Type Unspecified