Individual provider Active NPI

Thomas H.T. Lin, MEDICAL DIRECTOR

  • Pediatrics Physician
  • Monterey Park, CA
National Provider Identifier
1033210901
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A64211 Issued in CA
Practice address
725 S Atlantic Blvd Ste H
Monterey Park, CA 91754-3856
Phone
(626) 576-9929
Fax
(626) 576-2959
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A64211 CA
Pediatrics Physician 208000000X A64211 CA Primary

Addresses

Primary practice location

725 S Atlantic Blvd Ste H
Monterey Park, CA 91754-3856

Mailing address

PO Box 93723
City of Industry, CA 91715-3723
Phone (626) 308-0068

Other identifiers 3

IdentifierTypeStateIssuer
00A642110MedicaidCA
95-44848047OtherCATAX ID#
A64211OtherCASTATE LIC#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A64211CAMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1033210901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93723",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917153723",
            "telephone_number": "626-308-0068",
            "fax_number": "626-810-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ATLANTIC BLVD STE H",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543856",
            "telephone_number": "626-576-9929",
            "fax_number": "626-576-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "THOMAS",
        "middle_name": "H.T.",
        "credential": "MEDICAL DIRECTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A64211",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A64211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A642110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "95-44848047",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC#",
            "identifier": "A64211",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.