Provider Demographics
NPI:1265655211
Name:ELDRED, LINDA LEE (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:ELDRED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ELDRED
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9601 KIEFER BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3818
Mailing Address - Country:US
Mailing Address - Phone:916-875-5015
Mailing Address - Fax:916-875-5734
Practice Address - Street 1:9601 KIEFER BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3818
Practice Address - Country:US
Practice Address - Phone:916-875-5015
Practice Address - Fax:916-875-5734
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG055835208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics