Healthcare Provider Details

I. General information

NPI: 1982692224
Provider Name (Legal Business Name): LINDA HALDERMAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 ROSE AVE SUITE C
SELMA CA
93662-3251
US

IV. Provider business mailing address

1142 ROSE AVE SUITE C
SELMA CA
93662-3251
US

V. Phone/Fax

Practice location:
  • Phone: 559-896-0006
  • Fax:
Mailing address:
  • Phone: 559-896-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA71587
License Number StateCA

VIII. Authorized Official

Name: DR. LINDA F HALDERMAN
Title or Position: OWNER
Credential: M.D.
Phone: 559-896-0006