Individual provider Active NPI

Charles Cheng-Wen Lin, MD

  • Internal Medicine Physician
  • San Gabriel, CA
National Provider Identifier
1982719225
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A34628 Issued in CA
Practice address
1034 S San Gabriel Blvd
San Gabriel, CA 91776-3113
Phone
(625) 287-8222
Fax
(626) 287-4863
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A34628 CA Primary

Addresses

Primary practice location

1034 S San Gabriel Blvd
San Gabriel, CA 91776-3113

Mailing address

1034 S San Gabriel Blvd
San Gabriel, CA 91776-3113
Phone (625) 287-8222

Other names 1

  • Charles Cheng-Wen Lin Other name

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
I20040317000442 CA Practitioner - Internal MedicinePractitioner - General Practice 2961392659 Practice locations: San Gabriel, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1034 S San Gabriel Blvd
San Gabriel, CA 91776-3113
Phone (626) 287-8222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34628CAMDInternal Medicine Physician
34628CAMDMassage Therapist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1982719225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763113",
            "telephone_number": "625-287-8222",
            "fax_number": "626-287-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763113",
            "telephone_number": "625-287-8222",
            "fax_number": "626-287-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "CHARLES",
        "middle_name": "CHENG-WEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A34628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "LIN",
            "middle_name": "CHENG-WEN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.