Organization
LONGEVITY CLINICS & RESEARCH INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM LIN (MANAGING DIRECTOR & CFO)
(626) 255-9755
Entity
Organization
Contact information
Practice address
400 E LIVE OAK AVE, ARCADIA, CA 91006-5619
(626) 662-0288
Mailing address
400 E LIVE OAK AVE, ARCADIA, CA 91006-5619
(626) 662-0288
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
246ZE0500X
EEG Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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