| Organization Name: | LIN MEDICAL GROUP, INC |
| NPI Number: | 1477881225 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIRASOL PINEDA (BILLING MANAGER) |
| Mailing Address: | 15477 Ventura Blvd Suite 100 Sherman Oaks |
| State: | CA US |
| Postal Code: | 914033046 |
| Phone Number: | 8189066900 |
| Fax Number: | 8189066903 |
| NPI Enumeration Date: | 12/04/2009 |
| NPI Last Update Date: | 09/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |