Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A7966 | CA |
N | 207Q00000X | Family Doctor | 20A7966 | CA |
NPI | 1285659276 |
---|---|
Provider Name | Eric I-Hung Lin |
First Address | Palos Verdes Peninsula, CA 90274-8525 |
Second Address | Torrance, CA 90505-8161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 22/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20A7966 | CA-LICENSE (01) | CA |
H85422 | (02) |