Individual provider Active NPI

Rubin C Lin, D.O.

  • Family Medicine Physician
  • Fontana, CA
National Provider Identifier
1679678916
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9047 Issued in CA
Practice address
16854 Ivy Ave
Fontana, CA 92335-1504
Phone
(909) 791-1000
Fax
(909) 389-1316
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9047 CA Primary

Addresses

Primary practice location

16854 Ivy Ave
Fontana, CA 92335-1504

Mailing address

16854 Ivy Ave
Fontana, CA 92335-1504
Phone (909) 791-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000635 CA Practitioner - Family Practice 5597840025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians

Practice addresses (Care Compare)

16888 Baseline Ave
Fontana, CA 92336-2083
Phone (855) 422-8029

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9047CAMDFamily Medicine Physician
9047CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity Physician Services PC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Namita Mohideen MD Inc CurrentSince Jul 17, 2023 Accepting new patients
County of San Bernardino PastSince Aug 27, 2023 Accepting new patients
Beaver Medical Group P C Family Medicine Past Accepting new patients

Locations

16465 Sierra Lakes Pkwy
Ste 115
Fontana, CA 92336
Phone (909) 823-8000

16854 Ivy Ave
Fontana, CA 92335
Phone (909) 422-8029

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1499 E Highland Ave
Sn Bernrdno, CA 92404
Phone (855) 422-8029

15237 Eleventh St
Ste C
Victorville, CA 92395
Phone (760) 493-9300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1679678916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-791-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-791-1000",
            "fax_number": "909-389-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "RUBIN",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.