Healthcare Provider Details

I. General information

NPI: 1942242045
Provider Name (Legal Business Name): RUTH CARLETON LINDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S ALVARADO ST
LOS ANGELES CA
90057
US

IV. Provider business mailing address

123 S ALVARADO ST
LOS ANGELES CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 213-989-7700
  • Fax: 213-201-2617
Mailing address:
  • Phone: 213-989-7700
  • Fax: 213-201-2617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA68038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: