Provider Demographics
NPI:1104982164
Name:LIN, DELLA M (MD)
Entity type:Individual
Prefix:MS
First Name:DELLA
Middle Name:M
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1329 LUSITANA STREET
Mailing Address - Street 2:SUITE 604
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2431
Mailing Address - Country:US
Mailing Address - Phone:808-531-1116
Mailing Address - Fax:808-524-7911
Practice Address - Street 1:1329 LUSITANA STREET
Practice Address - Street 2:SUITE 604
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2431
Practice Address - Country:US
Practice Address - Phone:808-531-1116
Practice Address - Fax:808-524-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2011-06-09
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Provider Licenses
StateLicense IDTaxonomies
HIMD 6712207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05485601Medicaid
E02828Medicare UPIN
HIH0000BDQFJMedicare ID - Type Unspecified