Provider Demographics
NPI:1740864420
Name:JAMES P LIN, MD, INC
Entity type:Organization
Organization Name:JAMES P LIN, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TAMIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HICKSON-KELTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-272-2221
Mailing Address - Street 1:400 E RINCON ST STE 106
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1389
Mailing Address - Country:US
Mailing Address - Phone:951-272-2221
Mailing Address - Fax:951-272-1113
Practice Address - Street 1:16300 SAND CANYON AVE STE 901
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3709
Practice Address - Country:US
Practice Address - Phone:949-453-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty