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General NPI Number Information
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NPI Number | 1346289824
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Entity Type | Individual
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Provider Name | LINDA DIANA BOSSERMAN M.D., F.A.C.P
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 1500 DUARTE RD
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City | DUARTE
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State | CA
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Zip | 91010-3012
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Country | US
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Telephone | 626-256-4673
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 512185
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City | LOS ANGELES
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State | CA
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Zip | 90051-0185
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Country | US
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Telephone | 626-775-3514
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Fax | 626-218-5310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G49004
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | G49004
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License Number State | CA
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