Provider Demographics
NPI:1679635254
Name:LIN, ANDREW Y (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:Y
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E REMINGTON DR STE 30
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2612
Mailing Address - Country:US
Mailing Address - Phone:408-739-5950
Mailing Address - Fax:
Practice Address - Street 1:500 E REMINGTON DR STE 30
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2612
Practice Address - Country:US
Practice Address - Phone:408-739-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG778821Medicaid
CA22456Medicare UPIN
CAG778821Medicaid