Provider Demographics
NPI:1033327697
Name:MOLMEN, LINDA LEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:MOLMEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 SAINT AUGUSTINE CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-2787
Mailing Address - Country:US
Mailing Address - Phone:209-723-6667
Mailing Address - Fax:
Practice Address - Street 1:2808 PARK AVE STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3375
Practice Address - Country:US
Practice Address - Phone:209-723-8144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6744174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00PT67440Medicare ID - Type Unspecified
CAR26705Medicare UPIN