Provider Demographics
NPI:1780721209
Name:LIN, TZU HUNG (LAC PHD OMD)
Entity type:Individual
Prefix:
First Name:TZU HUNG
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:LAC PHD OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-4009
Mailing Address - Country:US
Mailing Address - Phone:626-442-6668
Mailing Address - Fax:626-572-8588
Practice Address - Street 1:807 E GARVEY AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-3026
Practice Address - Country:US
Practice Address - Phone:626-572-8588
Practice Address - Fax:626-572-8565
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2766171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC002766Medicaid