Provider Demographics
NPI:1932299252
Name:LIN, GENE J (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:J
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:PO BOX 2215
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-2215
Mailing Address - Country:US
Mailing Address - Phone:562-298-6214
Mailing Address - Fax:
Practice Address - Street 1:15141 WHITTIER BLVD STE 220
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2171
Practice Address - Country:US
Practice Address - Phone:562-696-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69919207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1144418773OtherGROUP NPI
CA1932299252OtherINDIVIDUAL NPI
CA1144418773OtherGROUP NPI
CA1932299252OtherINDIVIDUAL NPI
CAG69919AMedicare ID - Type Unspecified
CAW18107AMedicare ID - Type Unspecified
CAG69919Medicare ID - Type Unspecified