Healthcare Provider Details

I. General information

NPI: 1083393821
Provider Name (Legal Business Name): LINKEN TU CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BRISTOL ST
COSTA MESA CA
92626-5981
US

IV. Provider business mailing address

21217 WASHINGTON AVE SPC 94
WALNUT CA
91789-3342
US

V. Phone/Fax

Practice location:
  • Phone: 840-240-9500
  • Fax: 840-240-9500
Mailing address:
  • Phone: 909-470-7889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number93976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: