Provider Demographics
NPI:1407277155
Name:LIN, BINGTAO (MD)
Entity Type:Individual
Prefix:
First Name:BINGTAO
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1600 CREEKSIDE DR STE 2400
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3485
Mailing Address - Country:US
Mailing Address - Phone:916-932-4163
Mailing Address - Fax:916-932-4167
Practice Address - Street 1:1600 CREEKSIDE DR STE 2400
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3485
Practice Address - Country:US
Practice Address - Phone:916-932-4163
Practice Address - Fax:916-932-4167
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-25
Last Update Date:2018-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1417612081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine