Provider Demographics
NPI:1568229912
Name:LIN, FRANK FANXU
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:FANXU
Last Name:LIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3594 WHITE SANDS WAY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7056
Mailing Address - Country:US
Mailing Address - Phone:229-520-9822
Mailing Address - Fax:
Practice Address - Street 1:1100 N PALM CANYON DR STE 206
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4426
Practice Address - Country:US
Practice Address - Phone:760-883-1600
Practice Address - Fax:760-520-6644
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270826363LA2100X
CA95033471363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care