Basic Information
| Provider Information | |||||||||
| NPI: | 1164683876 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | ELINOR | ||||||||
| MiddleName: | YEN-RU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1045 ATLANTIC AVE | ||||||||
| Address2: | SUITE 719 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908133408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624371054 | ||||||||
| FaxNumber: | 5624249990 | ||||||||
| Practice Location | |||||||||
| Address1: | 1045 ATLANTIC AVE | ||||||||
| Address2: | SUITE 719 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908133408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624371054 | ||||||||
| FaxNumber: | 5624249990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 02/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | MT193007 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2084N0400X | A110043 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.