MEDICARE: LINDA DONOFRIO

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	207L00000X	Anesthesiology Physician	G60347	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437228962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA DONOFRIO

Provider Business Mailing Address
First Line	:	1619 THAYER AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6008
Country	:	US
Telephone Number	:	310-350-0606
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 SAN VICENTE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4404
Country	:	US
Telephone Number	:	310-350-0606
Fax Number	:

Authorized Official
Title or Position	:	M.D.
Name	:	LINDA DONOFRIO
Credential	:
Telephone Number	:	310-350-0606

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	01/18/2008

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Directions to “LINDA DONOFRIO ” Practice Location

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