Provider Demographics
NPI:1528181500
Name:LIN, JASON CHEN (CMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:CHEN
Last Name:LIN
Suffix:
Gender:M
Credentials:CMD
Other - Prefix:DR
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMD
Mailing Address - Street 1:20940 STEVENS CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2170
Mailing Address - Country:US
Mailing Address - Phone:408-865-1898
Mailing Address - Fax:
Practice Address - Street 1:20940 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2170
Practice Address - Country:US
Practice Address - Phone:408-865-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2765204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM