Provider Demographics
NPI:1811968464
Name:LIN, FANG L (MD)
Entity type:Individual
Prefix:DR
First Name:FANG
Middle Name:L
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11317 E SAN RAPHAEL DRIVEWAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-8613
Mailing Address - Country:US
Mailing Address - Phone:619-524-1519
Mailing Address - Fax:619-524-1673
Practice Address - Street 1:ALLERGY CLINIC, NTC
Practice Address - Street 2:2650 STOCKTON ROAD
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106
Practice Address - Country:US
Practice Address - Phone:619-524-1519
Practice Address - Fax:619-524-1673
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA30789207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy