Organization Name: | MARK S. LINAM, DPM, INC |
NPI Number: | 1164657623 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GINA D RODRIGUEZ (OFFICE MANAGER) |
Mailing Address: | 16660 Paramount Blvd Suite 101 Paramount |
State: | CA US |
Postal Code: | 907235433 |
Phone Number: | 5626330976 |
Fax Number: | 5626338470 |
NPI Enumeration Date: | 05/27/2009 |
NPI Last Update Date: | 05/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | E3500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |