Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E4342 | CA |
Y | 222Z00000X | Podiatrist | E4342 | CA |
NPI | 1053495127 |
---|---|
Provider Name | David C. Lin |
First Address | Oakland, CA 94612-3466 |
Second Address | San Rafael, CA 94903-3308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 22/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E43420 | (05) | CA |
V01323 | (02) |