Provider Demographics
NPI:1538428354
Name:LIN, CHRISTINA (RD, CDE)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9461 CHARLEVILLE BLVD
Mailing Address - Street 2:406
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3017
Mailing Address - Country:US
Mailing Address - Phone:310-270-3826
Mailing Address - Fax:
Practice Address - Street 1:9461 CHARLEVILLE BLVD
Practice Address - Street 2:406
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3017
Practice Address - Country:US
Practice Address - Phone:310-270-3826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA845861133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered