Healthcare Provider Details

I. General information

NPI: 1144362278
Provider Name (Legal Business Name): ALAN MARTIN LINDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17251 HESPERIAN BLVD
SAN LORENZO CA
94580-3150
US

IV. Provider business mailing address

17251 HESPERIAN BLVD
SAN LORENZO CA
94580-3150
US

V. Phone/Fax

Practice location:
  • Phone: 510-276-4653
  • Fax: 510-276-3150
Mailing address:
  • Phone: 510-276-4653
  • Fax: 510-276-3150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberC34386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: