Provider Demographics
NPI:1891884011
Name:LIN, YENCHIH GEORGE (MD)
Entity type:Individual
Prefix:
First Name:YENCHIH
Middle Name:GEORGE
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2560 HIGHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4890
Mailing Address - Country:US
Mailing Address - Phone:909-902-5288
Mailing Address - Fax:909-902-5387
Practice Address - Street 1:13141 CENTRAL AVE
Practice Address - Street 2:SUITE F
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4100
Practice Address - Country:US
Practice Address - Phone:909-902-5288
Practice Address - Fax:909-902-5387
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA61257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A612571Medicaid
CA00A612570Medicare PIN
CAG72709Medicare UPIN