Provider Demographics
NPI:1518166941
Name:LIN, TINA CHIN-YEH (DO)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:CHIN-YEH
Last Name:LIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2335 E KASHIAN LN
Practice Address - Street 2:SUITE 301
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2230
Practice Address - Country:US
Practice Address - Phone:559-264-9100
Practice Address - Fax:559-264-9199
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2424292084N0400X
CA20A93662084N0600X, 208M00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518166941OtherMEDI CAL
CAGG492ZMedicare PIN