Provider Demographics
NPI:1962898759
Name:LIN, ALEXANDER JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JUSTIN
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5624 TAPPAN DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2285
Mailing Address - Country:US
Mailing Address - Phone:949-844-0307
Mailing Address - Fax:
Practice Address - Street 1:645 N ARLINGTON AVE STE 120
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4441
Practice Address - Country:US
Practice Address - Phone:775-770-7410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-231552085R0001X
CA1743092085R0001X
MO20200099092085R0001X
NV213802085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology