Provider Demographics
NPI:1093753899
Name:WOLBERS, LINDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:WOLBERS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:15047 LOS GATOS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2054
Mailing Address - Country:US
Mailing Address - Phone:408-364-6799
Mailing Address - Fax:408-378-4510
Practice Address - Street 1:4400 CAPITOLA RD STE 200
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3571
Practice Address - Country:US
Practice Address - Phone:831-426-9302
Practice Address - Fax:408-378-4510
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG080646208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
356198100OtherUS DEPT OF LABOR
H56920Medicare UPIN
CACA138145Medicare PIN