Provider Demographics
NPI:1164648390
Name:LIN, SI ZHE
Entity type:Individual
Prefix:
First Name:SI
Middle Name:ZHE
Last Name:LIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 LOBER PL
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1841
Mailing Address - Country:US
Mailing Address - Phone:626-383-9298
Mailing Address - Fax:626-292-1632
Practice Address - Street 1:6506 LOBER PL
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1841
Practice Address - Country:US
Practice Address - Phone:626-383-9298
Practice Address - Fax:626-292-1632
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist