Provider Demographics
NPI:1922427020
Name:LIN, ALICE (DO)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:YEA
Other - Middle Name:WEN
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 W PUEBLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4353
Mailing Address - Country:US
Mailing Address - Phone:805-682-7111
Mailing Address - Fax:
Practice Address - Street 1:400 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4353
Practice Address - Country:US
Practice Address - Phone:805-682-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO4154208D00000X
390200000X
CA14854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program