Provider Demographics
NPI:1255395398
Name:LIN, HORNG JYH (MD)
Entity type:Individual
Prefix:DR
First Name:HORNG
Middle Name:JYH
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRUCE HORNG
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1095 HIAWATHA CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6957
Mailing Address - Country:US
Mailing Address - Phone:510-608-6185
Mailing Address - Fax:
Practice Address - Street 1:559 ABBOTT ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4325
Practice Address - Country:US
Practice Address - Phone:831-775-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA886572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A886570Medicaid
AN721YMedicare PIN
AN721VMedicare PIN
CAH35526Medicare UPIN
CA00A886570Medicaid
AN721WMedicare PIN
AN721XMedicare PIN
00A886570Medicare PIN