Provider Demographics
NPI:1376529537
Name:LINDER, JOHN ARTHUR (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:LINDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3623 W. WARD AVE.
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-7921
Mailing Address - Country:US
Mailing Address - Phone:760-377-5750
Mailing Address - Fax:
Practice Address - Street 1:3623 W WARD AVE
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-7921
Practice Address - Country:US
Practice Address - Phone:760-377-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1838213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WE 2952Medicare ID - Type Unspecified
T 11071Medicare UPIN