Provider Demographics
NPI:1033265780
Name:WASSERMAN, LINDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 WEST ARBOR DRIVE
Mailing Address - Street 2:MC 0639
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-0639
Mailing Address - Country:US
Mailing Address - Phone:858-534-8955
Mailing Address - Fax:858-534-0269
Practice Address - Street 1:200 WEST ARBOR DRIVE
Practice Address - Street 2:MC 0639
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-0639
Practice Address - Country:US
Practice Address - Phone:858-534-8955
Practice Address - Fax:858-534-0269
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67479207SG0205X, 207ZP0007X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0205XAllopathic & Osteopathic PhysiciansMedical GeneticsPh.D. Medical Genetics
Not Answered207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology