Provider Demographics
NPI:1134258213
Name:LIN, TERRY C (DO)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2520 SAMARITAN DR STE 201B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4106
Mailing Address - Country:US
Mailing Address - Phone:408-358-6580
Mailing Address - Fax:408-358-6515
Practice Address - Street 1:2520 SAMARITAN DR STE 201B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4106
Practice Address - Country:US
Practice Address - Phone:408-358-6580
Practice Address - Fax:408-358-6515
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65180207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00107274OtherMEDICARE ID