Provider Demographics
NPI:1538235031
Name:LIN, BING (LAC)
Entity type:Individual
Prefix:MR
First Name:BING
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1687 ERRINGER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-577-9938
Mailing Address - Fax:805-577-9938
Practice Address - Street 1:1687 ERRINGER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-577-9938
Practice Address - Fax:805-577-9938
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0075980Medicaid