MEDICARE: LINDA M FITZGERALD RPT

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	225100000X	Physical Therapist	194144	CA

General Provider Information

NPI Number	:	1790719847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA M FITZGERALD RPT

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23595 MOULTON PKWY STE E
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1939
Country	:	US
Telephone Number	:	949-218-0853
Fax Number	:	949-218-0856

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/19/2026

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