Individual
JEN-GU LIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(909) 558-4910
Mailing address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(909) 558-4910
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95013806
CA
Other
Enumeration date
10/05/2012
Last updated
04/30/2020
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