Provider Demographics
NPI:1376792820
Name:LEGASPI, LINDA ENGRACIA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ENGRACIA
Last Name:LEGASPI
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 1:16841 N 31ST AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3012
Mailing Address - Country:US
Mailing Address - Phone:602-789-8282
Mailing Address - Fax:602-789-1989
Practice Address - Street 1:16841 N 31ST AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3012
Practice Address - Country:US
Practice Address - Phone:602-789-8282
Practice Address - Fax:602-789-1989
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99855Medicare UPIN