Provider Demographics
NPI:1063893238
Name:LIN, JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 E IMPERIAL HWY STE 158
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6121
Mailing Address - Country:US
Mailing Address - Phone:714-671-1158
Mailing Address - Fax:714-671-1701
Practice Address - Street 1:2500 E IMPERIAL HWY STE 158
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6121
Practice Address - Country:US
Practice Address - Phone:714-671-1158
Practice Address - Fax:714-671-1701
Is Sole Proprietor?:No
Enumeration Date:2015-06-14
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY51411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist