Provider Demographics
NPI:1649234154
Name:LIN-DILORINZO, IRENE M (OD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:M
Last Name:LIN-DILORINZO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:IRENE
Other - Middle Name:M
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:32932 PACIFIC COAST HWY
Mailing Address - Street 2:STE 13
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3467
Mailing Address - Country:US
Mailing Address - Phone:949-487-3937
Mailing Address - Fax:949-487-3913
Practice Address - Street 1:32932 PACIFIC COAST HWY
Practice Address - Street 2:STE 13
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3467
Practice Address - Country:US
Practice Address - Phone:949-487-3937
Practice Address - Fax:949-487-3913
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9909T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0099090Medicaid
CAU44136Medicare UPIN
CAW18091Medicare ID - Type Unspecified