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NPI Code Detail

MEDICARE: DR. LINDA M VANSON

MEDICARE:  DR. LINDA M VANSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry47576CA

General Provider Information

NPI Number : 1073760526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA M VANSON
Provider Business Mailing Address
First Line : 2860 MICHELLE
Second Line : 2ND FLOOR
City : IRVINE
State : CA
Zip : 92606-1009
Country : US
Telephone Number : 714-508-3600
Fax Number : 714-368-2092
Provider Business Practice Location Address
First Line : 30592 SANTA MARGARITA PKWY
Second Line : STE D
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-5802
Country : US
Telephone Number : 949-766-5740
Fax Number : 949-766-6506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 08/26/2008

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Directions to “ DR. LINDA M VANSON ” Practice Location

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