MEDICARE: LINDA URIBE PHARM. D.

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
1	183500000X	Pharmacist	70088	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	70088	OTHER	CA	RPH LICENSE

General Provider Information

NPI Number	:	1215350798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA URIBE PHARM. D.

Provider Business Mailing Address
First Line	:	4711 RICHWOOD AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1319
Country	:	US
Telephone Number	:	626-824-3941
Fax Number	:

Provider Business Practice Location Address
First Line	:	4711 RICHWOOD AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1319
Country	:	US
Telephone Number	:	626-824-3941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/04/2014

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