Provider Demographics
NPI:1093024861
Name:RANK, LINDA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:RANK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 CORPORATE DR
Mailing Address - Street 2:STE 150
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-2136
Mailing Address - Country:US
Mailing Address - Phone:949-481-8881
Mailing Address - Fax:949-481-6666
Practice Address - Street 1:777 CORPORATE DR
Practice Address - Street 2:STE 150
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2136
Practice Address - Country:US
Practice Address - Phone:949-481-8881
Practice Address - Fax:949-481-6666
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16152363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical