Provider Demographics
NPI:1316979479
Name:LIN, ALBERT L (PA)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:L
Last Name:LIN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1010 W LA VETA AVE
Mailing Address - Street 2:SUITE 710
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4300
Mailing Address - Country:US
Mailing Address - Phone:714-835-2724
Mailing Address - Fax:714-835-2752
Practice Address - Street 1:1010 W LA VETA AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4300
Practice Address - Country:US
Practice Address - Phone:714-835-2724
Practice Address - Fax:714-835-2752
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAPA17832363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPA17832AMedicare ID - Type Unspecified
Q48578Medicare UPIN