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General NPI Number Information
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NPI Number | 1720347719
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Entity Type | Individual
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Provider Name | LINDA MAE BUNDY APRN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 11386 PLEASANT VALLEY RD
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City | PENN VALLEY
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State | CA
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Zip | 95946-9000
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Country | US
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Telephone | 530-451-6234
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Fax | 800-603-0374
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Provider Business Mailing Address
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Address Line | 11386 PLEASANT VALLEY RD
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City | PENN VALLEY
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State | CA
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Zip | 95946-9000
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Country | US
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Telephone | 530-451-6234
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Fax | 800-603-0374
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 21572
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License Number State | CA
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