Provider Demographics
NPI:1144223611
Name:EGLIN, LINDA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:EGLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15899 LOS GATOS ALMADEN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3739
Mailing Address - Country:US
Mailing Address - Phone:408-358-0838
Mailing Address - Fax:408-358-0280
Practice Address - Street 1:15899 LOS GATOS ALMADEN RD STE 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3739
Practice Address - Country:US
Practice Address - Phone:408-358-0838
Practice Address - Fax:408-358-0280
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56212207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A56212Medicare ID - Type Unspecified
CAG63544Medicare UPIN