Provider Demographics
NPI:1407947906
Name:LIN, XINYI (LAC)
Entity Type:Individual
Prefix:
First Name:XINYI
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5404
Mailing Address - Country:US
Mailing Address - Phone:510-748-0382
Mailing Address - Fax:
Practice Address - Street 1:345 9TH ST
Practice Address - Street 2:209
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6522
Practice Address - Country:US
Practice Address - Phone:510-268-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3081171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0030810Medicaid