Individual provider Active NPI

Robert T Lin, M.D.

  • Ophthalmology Physician
  • City of Industry, CA
National Provider Identifier
1760456248
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A55952 Issued in CA
Practice address
18725 Gale Ave
Ste 140
City of Industry, CA 91748-1354
Phone
(626) 854-2020
Fax
(626) 854-2021
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A55952 CA Primary

Addresses

Primary practice location

18725 Gale Ave
Ste 140
City of Industry, CA 91748-1354

Mailing address

18725 Gale Ave
Ste 140
City of Industry, CA 91748-1354
Phone (626) 854-2020

Other identifiers 2

IdentifierTypeStateIssuer
00A559520MedicaidCA
954750920OtherCATAX ID

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
I20090225000387 CA Practitioner - Ophthalmology 9133285240 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55952CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 26, 2007 Accepting new patients
County of Los Angeles CurrentSince Dec 26, 2007 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1760456248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18725 GALE AVE",
            "address_2": "STE 140",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481354",
            "telephone_number": "626-854-2020",
            "fax_number": "626-854-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18725 GALE AVE",
            "address_2": "STE 140",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481354",
            "telephone_number": "626-854-2020",
            "fax_number": "626-854-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "ROBERT",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A55952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A559520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "954750920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

Verify at the official NPI Registry.