Provider Demographics
NPI:1184770232
Name:LIN, YEUAN JONG (MD)
Entity type:Individual
Prefix:
First Name:YEUAN
Middle Name:JONG
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 1:4000 SAN DIMAS
Mailing Address - Street 2:#2
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-327-1401
Mailing Address - Fax:661-325-6858
Practice Address - Street 1:4000 SAN DIMAS
Practice Address - Street 2:#2
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-327-1401
Practice Address - Fax:661-325-6858
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A366630207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A28A2814Medicare UPIN