Provider Demographics
NPI:1457449969
Name:LIN, TAI-HON (MD)
Entity Type:Individual
Prefix:DR
First Name:TAI-HON
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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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21350 HAWTHORNE BLVD
Mailing Address - Street 2:STE #161
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5605
Mailing Address - Country:US
Mailing Address - Phone:310-541-8659
Mailing Address - Fax:310-543-9838
Practice Address - Street 1:21350 HAWTHORNE BLVD
Practice Address - Street 2:STE #161
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5605
Practice Address - Country:US
Practice Address - Phone:310-541-8659
Practice Address - Fax:310-543-9838
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA35727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A357270Medicaid
CA00A357270Medicaid
CAB50300Medicare UPIN