Provider Demographics
NPI:1750450359
Name:LIN, ANITA MING-CHU (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:MING-CHU
Last Name:LIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 ANGELCREST DR
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4418
Mailing Address - Country:US
Mailing Address - Phone:626-336-9913
Mailing Address - Fax:
Practice Address - Street 1:2221 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2207
Practice Address - Country:US
Practice Address - Phone:213-483-3929
Practice Address - Fax:213-483-4803
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH44629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH44629OtherPHARMACIST LICENSE