MEDICARE: CAROL A LINDBERG MD INCORPORATED

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	101YM0800X	Mental Health Counselor	G215920	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G215920	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1851628689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROL A LINDBERG MD INCORPORATED

Provider Business Mailing Address
First Line	:	344 TEJON PL
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-1204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	344 TEJON PL
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-1204
Country	:	US
Telephone Number	:	310-378-0565
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	CAROL LINDBERG
Credential	:
Telephone Number	:	310-378-0565

Provider Enumeration Date	:	11/16/2009
Last Update Date	:	03/13/2024

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