Healthcare Provider Details

I. General information

NPI: 1104888395
Provider Name (Legal Business Name): LINDA K MATSUNAGA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: LINDA K LOWE PHARMD

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2179 SHAW AVE
CLOVIS CA
93611-8937
US

IV. Provider business mailing address

2179 SHAW AVE
CLOVIS CA
93611-8937
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-1707
  • Fax: 559-298-4820
Mailing address:
  • Phone: 559-298-1707
  • Fax: 559-298-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: