Provider Demographics
NPI:1497773212
Name:LINEHAN, MOLLY PRINDIVILLE (MD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:PRINDIVILLE
Last Name:LINEHAN
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 1:3801 SACRAMENTO ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1625
Mailing Address - Country:US
Mailing Address - Phone:415-600-2402
Mailing Address - Fax:415-600-6304
Practice Address - Street 1:3801 SACRAMENTO ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1625
Practice Address - Country:US
Practice Address - Phone:415-600-2402
Practice Address - Fax:415-600-6304
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70501208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A705011Medicare PIN
CAH50352Medicare UPIN