Provider Demographics
NPI:1750865358
Name:BINGTAO LIN, MD, PC
Entity Type:Organization
Organization Name:BINGTAO LIN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:D'ANTONOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-932-4163
Mailing Address - Street 1:1600 CREEKSIDE DR STE 2400
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3485
Mailing Address - Country:US
Mailing Address - Phone:916-932-4163
Mailing Address - Fax:916-932-4167
Practice Address - Street 1:1600 CREEKSIDE DR STE 2400
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3485
Practice Address - Country:US
Practice Address - Phone:916-932-4163
Practice Address - Fax:916-932-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty