Provider Demographics
NPI:1518963719
Name:LIN, ANDREW YUH-FONG (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:YUH-FONG
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:YUH FONG
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:23600 TELO AVE
Mailing Address - Street 2:STE 280
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4037
Mailing Address - Country:US
Mailing Address - Phone:310-784-8000
Mailing Address - Fax:310-784-8008
Practice Address - Street 1:23600 TELO AVE
Practice Address - Street 2:STE 280
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4037
Practice Address - Country:US
Practice Address - Phone:310-784-8000
Practice Address - Fax:310-784-8008
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-05-04
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
CAA37779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A377791Medicaid
CA00A377791Medicaid
CAA37779Medicare ID - Type Unspecified