Provider Demographics
NPI:1447270517
Name:LIN, CHIN HUA (DPM)
Entity type:Individual
Prefix:
First Name:CHIN HUA
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 E CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2922
Mailing Address - Country:US
Mailing Address - Phone:909-593-0086
Mailing Address - Fax:626-335-1313
Practice Address - Street 1:1219 E CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2922
Practice Address - Country:US
Practice Address - Phone:909-593-0086
Practice Address - Fax:626-335-1313
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4365213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16023Medicare ID - Type UnspecifiedGROUP NUMBER
CAU88922Medicare UPIN
CAWE4365BMedicare PIN