Provider Demographics
NPI:1164683876
Name:LIN, ELINOR YEN-RU (MD)
Entity type:Individual
Prefix:DR
First Name:ELINOR
Middle Name:YEN-RU
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE
Mailing Address - Street 2:SUITE 719
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3408
Mailing Address - Country:US
Mailing Address - Phone:562-437-1054
Mailing Address - Fax:562-424-9990
Practice Address - Street 1:1045 ATLANTIC AVE
Practice Address - Street 2:SUITE 719
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3408
Practice Address - Country:US
Practice Address - Phone:562-437-1054
Practice Address - Fax:562-424-9990
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA390200000X
PAMT193007207R00000X
CAA1100432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine