Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | A150393 | CA |
NPI | 1255794970 |
---|---|
Provider Name | Ryan Lin |
First Address | Los Altos, CA 94022-1408 |
Second Address | Dublin, CA 94568-3112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 18/06/2020 |