Provider Demographics
NPI:1811982291
Name:LIN, CHRISTOPHER (MD, FACS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 ONEIL LN
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4870
Mailing Address - Country:US
Mailing Address - Phone:707-443-9777
Mailing Address - Fax:707-445-1003
Practice Address - Street 1:2840 ONEIL LN
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4870
Practice Address - Country:US
Practice Address - Phone:707-443-9777
Practice Address - Fax:707-445-1003
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72980207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G729800Medicaid
CA00G729800Medicaid
WG72980AMedicare ID - Type Unspecified