Healthcare Provider Details

I. General information

NPI: 1902979842
Provider Name (Legal Business Name): DIANE MICHELLE LINDNER PT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E LAMBERT RD STE. 220
BREA CA
92821-4370
US

IV. Provider business mailing address

1800 E LAMBERT RD STE. 220
BREA CA
92821-4370
US

V. Phone/Fax

Practice location:
  • Phone: 714-256-5074
  • Fax:
Mailing address:
  • Phone: 714-256-5074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number35583
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6484
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: