Provider Demographics
NPI:1457473266
Name:MIGNANO, LINDA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ROSE
Last Name:MIGNANO
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 1:180 CALDECOTT LANE
Mailing Address - Street 2:UNIT 316
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618
Mailing Address - Country:US
Mailing Address - Phone:510-704-1763
Mailing Address - Fax:
Practice Address - Street 1:1900 SULLIVAN
Practice Address - Street 2:SETON MEDICAL CENTER DEPT OF ANESTHESIA
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-991-6511
Practice Address - Fax:650-756-6285
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65980207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology