Healthcare Provider Details

I. General information

NPI: 1922082403
Provider Name (Legal Business Name): LINDA ANN ARAGON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WALNUT AVE
MARE ISLE CA
94592
US

IV. Provider business mailing address

201 WALNUT AVE
MARE ISLE CA
94592
US

V. Phone/Fax

Practice location:
  • Phone: 707-562-8218
  • Fax: 707-562-8219
Mailing address:
  • Phone: 707-562-8218
  • Fax: 707-562-8219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA60473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: