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General NPI Number Information
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NPI Number | 1639343122
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Entity Type | Organization
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Legal Business Name | A LINN MEDICAL PRACTICE
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 4000 SAN DIMAS ST #2
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1296
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Country | US
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Telephone | 661-327-1401
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Fax | 661-325-6858
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Provider Business Mailing Address
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Address Line | 4000 SAN DIMAS ST #2
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1296
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Country | US
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Telephone | 661-327-1401
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Fax | 661-325-6858
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Authorized Official
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Title or Position | MD
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Name | MRS. REBECCA RIVERA
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Credential | MD
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Telephone | 661-327-1401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A53681
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License Number State | CA
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