Provider Demographics
NPI:1417124629
Name:LINAREZ, GLORIA (N/A)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:LINAREZ
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-4626
Mailing Address - Country:US
Mailing Address - Phone:951-686-8866
Mailing Address - Fax:951-686-9440
Practice Address - Street 1:5360 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-4626
Practice Address - Country:US
Practice Address - Phone:951-686-8866
Practice Address - Fax:951-686-9440
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA023962 RIVERSIDE CNT172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver