Healthcare Provider Details

I. General information

NPI: 1609814854
Provider Name (Legal Business Name): LINDA M. WARNER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA M. ARRE D.O.

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17871 SANTIAGO BLVD STE 206
VILLA PARK CA
92861-4118
US

IV. Provider business mailing address

17871 SANTIAGO BLVD STE 206
VILLA PARK CA
92861-4118
US

V. Phone/Fax

Practice location:
  • Phone: 714-974-1362
  • Fax: 714-974-3145
Mailing address:
  • Phone: 714-974-1362
  • Fax: 714-974-3145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A6111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: