Individual provider Active NPI

Paul Lin, O.D.

  • Optometrist
  • Palmdale, CA
National Provider Identifier
1710956016
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11428T Issued in CA
Practice address
2720 E Palmdale Blvd
Suite 133
Palmdale, CA 93550
Phone
(661) 341-6375
NPI assigned
Mar 17, 2006
Last updated
May 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11428T CA Primary

Addresses

Primary practice location

2720 E Palmdale Blvd
Suite 133
Palmdale, CA 93550

Mailing address

2720 E Palmdale Blvd
Suite 133
Palmdale, CA 93550-4930
Phone (661) 341-6375

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040331001693 CA Practitioner - Optometry 2668464504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11428TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Family Optometry, Inc Optometrist CurrentSince Sep 28, 2009 Accepting new patients
Antelope Valley Family Optometry, Inc Optometrist CurrentSince Sep 28, 2009 Accepting new patients
Antelope Valley Optometric Center, Inc. Optometrist PastSince Jan 1, 1992 Accepting new patients
Linden Optometry a Professional Corporation Optometrist PastSince Mar 1, 1999 Accepting new patients

Locations

2720 E Palmdale Blvd
Ste 133
Palmdale, CA 93550
Phone (661) 267-0026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1710956016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD",
            "address_2": "SUITE 133",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504930",
            "telephone_number": "661-341-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD",
            "address_2": "SUITE 133",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93550",
            "telephone_number": "661-341-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11428T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.