MEDICARE: LINNA LY PHARMD

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	75167	CA

General Provider Information

NPI Number	:	1801347562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINNA LY PHARMD

Provider Business Mailing Address
First Line	:	1719 E WALNUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1611
Country	:	US
Telephone Number	:	626-798-6789
Fax Number	:

Provider Business Practice Location Address
First Line	:	1719 E WALNUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1611
Country	:	US
Telephone Number	:	626-798-6789
Fax Number	:

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

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/14/2022

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Directions to “ LINNA LY PHARMD” Practice Location

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