Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 8206 | NV |
NPI | 1235170820 |
---|---|
Provider Name | Dr. Alvin B Lin |
First Address | Las Vegas, NV 89148 |
Second Address | Las Vegas, NV 89148-3601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 19/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100500484 | (05) | NV |
100504439 | MEDICAID NUMBER (01) | NV |
8206 | NEVADA LICENSE (01) | NV |
BL3426017 | DEA LICENSE (01) | NV |
CS08928 | PHARMACY LICENSE (01) | NV |
F41468 | (02) | NV |