Provider Demographics
NPI:1841271814
Name:LIN, ALLEN I (DO)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:I
Last Name:LIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2912 BUCKMINSTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7625
Mailing Address - Country:US
Mailing Address - Phone:916-690-7706
Mailing Address - Fax:916-691-1889
Practice Address - Street 1:2912 BUCKMINSTER DRIVE
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7625
Practice Address - Country:US
Practice Address - Phone:916-690-7706
Practice Address - Fax:916-691-1889
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8777207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine