Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A123876 | CA |
NPI | 1033440912 |
---|---|
Provider Name | Benjamin Lin |
First Address | Calabasas, CA 91302-4033 |
Second Address | Calabasas, CA 91302-4033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2010 |
Last Update Date | 06/12/2021 |