Provider Demographics
NPI:1730131236
Name:LIN, SHAN C (MD)
Entity type:Individual
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First Name:SHAN
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:55 STEVENSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-2936
Mailing Address - Country:US
Mailing Address - Phone:415-981-2020
Mailing Address - Fax:415-981-2019
Practice Address - Street 1:400 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-2608
Practice Address - Fax:415-476-0336
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-04-17
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Provider Licenses
StateLicense IDTaxonomies
CAG83098207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G830980Medicaid
CAG68471Medicare UPIN
CA00G830980Medicaid