Provider Demographics
NPI:1598824484
Name:LIN, DONNY I-FON (PT)
Entity type:Individual
Prefix:MR
First Name:DONNY
Middle Name:I-FON
Last Name:LIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 COLLARD WAY
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-8212
Mailing Address - Country:US
Mailing Address - Phone:714-271-7578
Mailing Address - Fax:714-528-1718
Practice Address - Street 1:432 COLLARD WAY
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-8212
Practice Address - Country:US
Practice Address - Phone:714-271-7578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist