Provider Demographics
NPI:1457668436
Name:LIN, DAVID (LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:CHIA
Other - Middle Name:WEI
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10050 GARVEY AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2089
Mailing Address - Country:US
Mailing Address - Phone:626-582-5856
Mailing Address - Fax:
Practice Address - Street 1:10050 GARVEY AVE STE 103
Practice Address - Street 2:#103
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2089
Practice Address - Country:US
Practice Address - Phone:626-780-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist