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General NPI Number Information
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NPI Number | 1124353057
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Entity Type | Organization
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Legal Business Name | LINDA GERRITS M D INC A PROFESSIONAL CORP
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 1220 LA VENTA DR SUITE 207
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3703
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Country | US
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Telephone | 805-494-7710
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Fax | 805-494-7793
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Provider Business Mailing Address
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Address Line | 1220 LA VENTA DR SUITE 207
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3703
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Country | US
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Telephone | 805-494-7710
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Fax | 805-494-7793
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LINDA M GERRITS
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Credential | M.D.
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Telephone | 805-494-7710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G55503
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License Number State | CA
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