Provider Demographics
NPI:1245251842
Name:YIHSIANG LIN CHIROPRACTIC PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:YIHSIANG LIN CHIROPRACTIC PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:YI-HSIANG
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-444-8588
Mailing Address - Street 1:2020 S HACIENDA BLVD
Mailing Address - Street 2:D
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4265
Mailing Address - Country:US
Mailing Address - Phone:626-855-1158
Mailing Address - Fax:626-369-9654
Practice Address - Street 1:2020 S HACIENDA BLVD
Practice Address - Street 2:D
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4265
Practice Address - Country:US
Practice Address - Phone:626-855-1158
Practice Address - Fax:626-605-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
CAAC8087171100000X
CAAC6617171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU80415Medicare UPIN
CAW18947Medicare ID - Type Unspecified