| Jay J. Lin M.d. Inc | |
|
22030 Sherman Way Suite 201 Canoga Park CA 91303-1855 | |
| (818) 883-6840 | |
| (818) 883-8828 |
| Full Name | Jay J. Lin M.d. Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 22030 Sherman Way, Canoga Park, California |
| Authorized Official Name and Position | Jay J. Lin (OWNER) |
| Authorized Official Contact | 8188836840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay J. Lin M.d. Inc 22030 Sherman Way Suite 201 Canoga Park CA 91303-1855 Ph: (818) 883-6840 | Jay J. Lin M.d. Inc 22030 Sherman Way Suite 201 Canoga Park CA 91303-1855 Ph: (818) 883-6840 |
| NPI Number | 1962437434 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 04/12/2008 |
| Medicare PECOS PAC ID | 8325120967 |
|---|---|
| Medicare Enrollment ID | O20080204000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962437434 | NPI | - | NPPES |
| 00A314260 | Medicaid | CA | |
| W21632 | Other | CA | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | A31426 (California) | Secondary |
| Provider Name | Jay J Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275551251 PECOS PAC ID: 5698857233 Enrollment ID: I20080204000758 |
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