Provider Demographics
NPI:1982820106
Name:LIN, LESTER (DC)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23548 CALABASAS RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1314
Mailing Address - Country:US
Mailing Address - Phone:818-884-4000
Mailing Address - Fax:818-884-4555
Practice Address - Street 1:23548 CALABASAS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1314
Practice Address - Country:US
Practice Address - Phone:818-884-4000
Practice Address - Fax:818-884-4555
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26431Medicare UPIN