Provider Demographics
NPI:1528164894
Name:LYNN, THYNN THYNN (MD)
Entity type:Individual
Prefix:
First Name:THYNN
Middle Name:THYNN
Last Name:LYNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 E.ARQUES AVENUE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085
Mailing Address - Country:US
Mailing Address - Phone:408-735-7695
Mailing Address - Fax:408-735-8150
Practice Address - Street 1:1210 E.ARQUES AVENUE
Practice Address - Street 2:SUITE 209
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085
Practice Address - Country:US
Practice Address - Phone:408-735-7695
Practice Address - Fax:408-735-8150
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA492772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF99789Medicare UPIN
CA00A492770Medicare ID - Type Unspecified