Provider Demographics
NPI:1306326004
Name:LIN, CHAO HSIANG DOROTHY (LAC)
Entity type:Individual
Prefix:
First Name:CHAO HSIANG
Middle Name:DOROTHY
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 SOUTHSHORE CT
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5144
Mailing Address - Country:US
Mailing Address - Phone:408-886-8583
Mailing Address - Fax:
Practice Address - Street 1:11701 SOUTHSHORE CT
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5144
Practice Address - Country:US
Practice Address - Phone:408-886-8583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18183171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist