Provider Demographics
NPI:1457428351
Name:LIN, CHAO-MING CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAO-MING
Middle Name:CHARLES
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:C.
Other - Middle Name:CHARLES
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5145 CELLINI DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6146
Mailing Address - Country:US
Mailing Address - Phone:909-986-4692
Mailing Address - Fax:
Practice Address - Street 1:2232 S MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6132
Practice Address - Country:US
Practice Address - Phone:909-986-4692
Practice Address - Fax:909-986-1994
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine