Provider Demographics
NPI:1124307962
Name:JIAN CHENG LIN MD INC
Entity type:Organization
Organization Name:JIAN CHENG LIN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIAN
Authorized Official - Middle Name:CHENG
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-571-7389
Mailing Address - Street 1:1418 S SAN GABRIEL BLVD
Mailing Address - Street 2:STE #B
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-4604
Mailing Address - Country:US
Mailing Address - Phone:626-571-7389
Mailing Address - Fax:626-571-7311
Practice Address - Street 1:1418 S SAN GABRIEL BLVD
Practice Address - Street 2:STE #B
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-4604
Practice Address - Country:US
Practice Address - Phone:626-571-7389
Practice Address - Fax:626-571-7311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA681762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty