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General NPI Number Information
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NPI Number | 1508917204
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Entity Type | Organization
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Legal Business Name | MARK S LINAM DPM A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 12820 STUDEBAKER RD STE 200
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City | NORWALK
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State | CA
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Zip | 90650-2583
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Country | US
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Telephone | 562-868-0787
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Fax | 562-375-6188
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Provider Business Mailing Address
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Address Line | PO BOX 1204
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City | NORWALK
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State | CA
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Zip | 90651-1204
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Country | US
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Telephone | 562-868-0787
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Fax | 562-375-6188
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Authorized Official
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Title or Position | PODIATRISTSURGEON
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Name | DR. MARK SCOTT LINAM
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Credential | DPM
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Telephone | 562-868-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E3500
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License Number State | CA
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