Individual
DR. HENRY LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 SAN PEDRO DR SE, 111, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
1501 SAN PEDRO DR SE, 111, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G52549
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A525490
—
CA
01
—
00G525490
BLUE SHIELD
CA
01
—
1356390009
GROUP NPI
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID
CA
01
—
W11675
GROUP MEDICARE PIN
CA
Enumeration date
06/29/2006
Last updated
05/02/2013
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