Healthcare Provider Details

I. General information

NPI: 1851925754
Provider Name (Legal Business Name): DEBORAH ELIZABETH LINTON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8711 VENICE BLVD
LOS ANGELES CA
90034-3216
US

IV. Provider business mailing address

8715 S GRAMERCY PL
LOS ANGELES CA
90047-3204
US

V. Phone/Fax

Practice location:
  • Phone: 310-237-0023
  • Fax:
Mailing address:
  • Phone: 323-320-3869
  • Fax: 323-932-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: