Provider Demographics
NPI:1093871410
Name:ENEMARK, LINDA (DC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ENEMARK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 TRUXTUN AVE
Mailing Address - Street 2:SUITE # 120
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0679
Mailing Address - Country:US
Mailing Address - Phone:661-588-5706
Mailing Address - Fax:661-588-5706
Practice Address - Street 1:6001 TRUXTUN AVE
Practice Address - Street 2:SUITE # 120
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0679
Practice Address - Country:US
Practice Address - Phone:661-588-5706
Practice Address - Fax:661-588-5706
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17677111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU02782Medicare UPIN