Individual provider Active NPI

Lin Mao

  • General Practice Registered Nurse
  • Norwalk, CA
National Provider Identifier
1114435310
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
95004247 Issued in CA
Practice address
12164 Gridley Rd
Norwalk, CA 90650-7850
Phone
(562) 713-2093
NPI assigned
Jan 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WG0000X 95004247 CA Primary

Addresses

Primary practice location

12164 Gridley Rd
Norwalk, CA 90650-7850

Mailing address

12164 Gridley Rd
Norwalk, CA 90650-7850
Phone (562) 713-2093

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
95004247CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1114435310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12164 GRIDLEY RD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906507850",
            "telephone_number": "562-713-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12164 GRIDLEY RD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906507850",
            "telephone_number": "562-713-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAO",
        "first_name": "LIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95004247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.