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NPI Code Detail

MEDICARE: MRS. LINDA SUE RICHARDS PA-C

MEDICARE:  MRS. LINDA SUE RICHARDS  PA-C
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
1363A00000XPhysician AssistantPA11678CA

General Provider Information

NPI Number : 1316074529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA SUE RICHARDS PA-C
Provider Business Mailing Address
First Line : 1534 6TH ST
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6346
Country : US
Telephone Number : 310-937-9612
Fax Number : 310-937-9612
Provider Business Practice Location Address
First Line : 6330 VAN NUYS BLVD
Second Line :
City : VAN NUYS
State : CA
Zip : 91401-2610
Country : US
Telephone Number : 818-994-9822
Fax Number : 818-994-9821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. LINDA SUE RICHARDS PA-C” Practice Location

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