Organization Active NPI

Lawrence L Lin MD Professional Corporation

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Thousand Oaks, CA
National Provider Identifier
1073553590
Registry record updated May 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
LAWRENCE L LIN MD PROFESSIONAL CORPORATION
Practice address
1000 Newbury Rd Ste 165
Thousand Oaks, CA 91320-6439
Phone
(805) 449-1778
Fax
(805) 496-9970
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2022

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

Authorized official

Name
Lawrence L Lin, M.D.NPI 1114964202
Title
President
Phone
(805) 449-1778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VF0040X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

1000 Newbury Rd Ste 165
Thousand Oaks, CA 91320-6439

Mailing address

1000 Newbury Rd Ste 165
Thousand Oaks, CA 91320-6439
Phone (805) 449-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060613000129 CA Part B Supplier - Clinic/Group Practice 1456363415 Receives reassigned benefits from 2 practitioners
Practice locations: Thousand Oaks, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1071111Lawrence L Lin MD1000 Newbury Rd, Ste 165, Thousand Oaks, CA 91320Certificate of waiverJun 25, 2028

National Provider Directory

National Provider Directory

Locations

1000 Newbury Rd
Ste 165
Thousand Oaks, CA 91320
Phone (805) 449-1778

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651968000000",
    "number": "1073553590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 165",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206439",
            "telephone_number": "805-449-1778",
            "fax_number": "805-496-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 165",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206439",
            "telephone_number": "805-449-1778",
            "fax_number": "805-496-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE L LIN MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-449-1778",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.