Doctor Name: | DR. LINDA JEAN SIDWELL |
NPI Number: | 1932181633 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | C39639 |
Business Practice Address: | 5342 Dudley Blvd Mcclellan, CA - 956521012 |
Business Phone Number: | 9165617502 |
Business Fax Number: | 9165617440 |
Mailing Address: | 11383 Yuba Ridge Dr, NEVADA CITY |
State: | CA |
Postal Code: | 959599735 |
Phone Number: | 5302720546 |
Fax Number: | 9165617440 |
NPI Enumeration Date: | 11/17/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C39639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |