Wong, Tan Lin

Wong, Tan Lin is an individual health care provider with primary practice located at 2100 Foothill Blvd Ste A , La Verne CA 91750-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wong, Tan Lin can be contacted via phone (909) 596-1941.

Contact Information

Primary practice address
2100 Foothill Blvd Ste A La Verne CA 91750-2905
Phone: (909) 596-1941
Fax: (909) 596-1943
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A50496 California

Profile Details

NPI number 1790728749
LBN Legal business name Wong, Tan Lin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jan 4th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790728749 NPPES
California MEDICAID GR0083450
California Other W20443
California MEDICAID 00A504961

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