Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 56472 | CA |
NPI | 1215305610 |
---|---|
Provider Name | Dr. Richard Lin |
First Address | Los Angeles, CA 90013-1696 |
Second Address | Los Angeles, CA 90089-3262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2015 |
Last Update Date | 02/09/2015 |