NPIMap

Individual provider Active NPI

Lin Soe, MBBS, MPH, TM

  • Hematology & Oncology Physician
  • San Luis Obispo, CA
National Provider Identifier
1467524900
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A53258 Issued in CA
Practice address
715 Tank Farm Rd Ste C
San Luis Obispo, CA 93401-7068
Phone
(805) 543-5577
NPI assigned
Nov 13, 2006
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A53258 CA Primary

Addresses

Primary practice location

715 Tank Farm Rd Ste C
San Luis Obispo, CA 93401-7068

Mailing address

715 Tank Farm Rd Ste C
San Luis Obispo, CA 93401-7068
Phone (805) 543-5577

Other practice location 1

3102 Porte Morino Drive
Suite 100
Cameron Park, CA 95682-8236
Phone (530) 676-6600

Other identifiers 1

IdentifierTypeStateIssuer
00A532580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080211000863 CA Practitioner - Hematology/Oncology 2163505355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

117 W Bunny Ave
Santa Maria, CA 93458-2805
Phone (805) 739-3890

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

715 Tank Farm Rd
Suite C
San Luis Obispo, CA 93401-7068
Phone (805) 543-5577

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A53258CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers CurrentSince Nov 7, 2021 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Nov 7, 2021 Accepting new patients
Dignity Health Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

715 Tank Farm Rd
Ste C
San Luis Obispo, CA 93401
Phone (805) 543-5577

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1467524900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 TANK FARM RD STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017068",
            "telephone_number": "805-543-5577",
            "fax_number": "805-595-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 TANK FARM RD STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017068",
            "telephone_number": "805-543-5577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3102 Porte Morino Drive",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "956828236",
            "country_code": "US",
            "telephone_number": "530-676-6600",
            "fax_number": "530-676-6603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOE",
        "first_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "MBBS, MPH, TM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A53258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A532580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.