MEDICARE: LINDA FOSTER OPTOMETRY, INC.

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	152W00000X	Optometrist	10488T	CA

General Provider Information

NPI Number	:	1578924981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA FOSTER OPTOMETRY, INC.

Provider Business Mailing Address
First Line	:	4921 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1906
Country	:	US
Telephone Number	:	323-255-2221
Fax Number	:	888-741-7962

Provider Business Practice Location Address
First Line	:	4921 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1906
Country	:	US
Telephone Number	:	323-255-2221
Fax Number	:	888-741-7962

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LINDA FOSTER
Credential	:	O.D.
Telephone Number	:	323-255-2221

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	03/11/2016

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