Provider Demographics
NPI:1275560955
Name:HAMMER, LINDA (OD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HAMMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:818-768-3000
Mailing Address - Fax:818-504-4690
Practice Address - Street 1:1211 S FERN ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-2808
Practice Address - Country:US
Practice Address - Phone:703-847-8899
Practice Address - Fax:571-223-6780
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8635152W00000X
VA0618003335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0086350Medicaid
CASD0086350Medicaid
CAU76216Medicare UPIN