Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 172870 | CA |
NPI | 1275066524 |
---|---|
Provider Name | Wendy Lin |
First Address | San Antonio, TX 78251-1747 |
Second Address | Cathedral City, CA 92234-5441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 07/12/2021 |