Provider Demographics
NPI:1851888671
Name:INFINITY MEDICINE INC
Entity Type:Organization
Organization Name:INFINITY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-387-9997
Mailing Address - Street 1:9950 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4309
Mailing Address - Country:US
Mailing Address - Phone:949-387-9997
Mailing Address - Fax:949-387-9998
Practice Address - Street 1:9950 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4309
Practice Address - Country:US
Practice Address - Phone:949-387-9997
Practice Address - Fax:949-387-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG77036OtherCA MEDICAL BOARD LICENSE