Provider Demographics
NPI:1518052349
Name:PANOFSKY, LINDA V (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:V
Last Name:PANOFSKY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:V
Other - Last Name:GOOSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:LA HONDA
Mailing Address - State:CA
Mailing Address - Zip Code:94020-0186
Mailing Address - Country:US
Mailing Address - Phone:650-539-4067
Mailing Address - Fax:
Practice Address - Street 1:1500 OWENS ST STE 460
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2335
Practice Address - Country:US
Practice Address - Phone:650-539-4067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56779183500000X
OR0010779183500000X
ARPD10939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00071036OtherPHARMACIST LICENSE
CA56779OtherPHARMACIST LICENSE