Provider Demographics
NPI:1447954334
Name:LIN, KUAN-TUNG (MD)
Entity type:Individual
Prefix:
First Name:KUAN-TUNG
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 JUNIPERO SERRA BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1982
Mailing Address - Country:US
Mailing Address - Phone:415-391-9686
Mailing Address - Fax:
Practice Address - Street 1:1520 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-3354
Practice Address - Country:US
Practice Address - Phone:415-391-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program