Provider Demographics
NPI:1245260090
Name:LIN, WEN JUNG (MD)
Entity type:Individual
Prefix:DR
First Name:WEN
Middle Name:JUNG
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:515 SOUTH DR
Mailing Address - Street 2:SUITE 14
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4204
Mailing Address - Country:US
Mailing Address - Phone:650-966-1448
Mailing Address - Fax:650-966-8107
Practice Address - Street 1:515 SOUTH DR
Practice Address - Street 2:SUITE 14
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4204
Practice Address - Country:US
Practice Address - Phone:650-966-1448
Practice Address - Fax:650-966-8107
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA42424208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD19981Medicare UPIN