Individual provider Active NPI

Eduardo Lin, MD

  • Physical Medicine & Rehabilitation Physician
  • Pleasanton, CA
National Provider Identifier
1851350698
Registry record updated Oct 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A53538 Issued in CA
Practice address
6155 Stoneridge Dr
Ste 101
Pleasanton, CA 94588-3365
Phone
(925) 251-9451
Fax
(925) 251-0356
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A53538 CA Primary

Addresses

Primary practice location

6155 Stoneridge Dr
Ste 101
Pleasanton, CA 94588-3365

Mailing address

6155 Stoneridge Dr 101
Pleasanton, CA 94588-3365
Phone (925) 251-9451

Other practice location 1

632 W 11th St
Tracy, CA 95376-3856
Phone (209) 753-0111

Other identifiers 1

IdentifierTypeStateIssuer
CA233977MedicaidCA

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
I20050803000422 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 5890723597 Practice locations: Pleasanton, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6155 Stoneridge Dr
Suite 101
Pleasanton, CA 94588-3365
Phone (925) 251-9451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53538CAMDPhysical Medicine & Rehabilitation Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664582400000",
    "number": "1851350698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6155 STONERIDGE DR 101",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883365",
            "telephone_number": "925-251-9451",
            "fax_number": "925-251-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 STONERIDGE DR",
            "address_2": "STE 101",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883365",
            "telephone_number": "925-251-9451",
            "fax_number": "925-251-0356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 W 11th St",
            "address_purpose": "LOCATION",
            "city": "Tracy",
            "state": "CA",
            "postal_code": "953763856",
            "country_code": "US",
            "telephone_number": "209-753-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-10-01",
        "certification_date": "2022-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A53538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA233977",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.