MEDICARE: DR. LINDA MAIPHUONGLIEN HA M.D.

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	208000000X	Pediatrics Physician	A060284	CA

General Provider Information

NPI Number	:	1851328587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA MAIPHUONGLIEN HA M.D.

Provider Business Mailing Address
First Line	:	1569 LEXANN AVE
Second Line	:	SUITE 232
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1794
Country	:	US
Telephone Number	:	408-270-3374
Fax Number	:	408-270-3384

Provider Business Practice Location Address
First Line	:	1569 LEXANN AVE
Second Line	:	SUITE 232
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1794
Country	:	US
Telephone Number	:	408-270-3374
Fax Number	:	408-270-3384

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/15/2010

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