Provider Demographics
NPI:1629070198
Name:STERRY, LINDA (DO)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:STERRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:818-837-5559
Mailing Address - Fax:818-792-4793
Practice Address - Street 1:11333 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1116
Practice Address - Country:US
Practice Address - Phone:818-837-5554
Practice Address - Fax:213-977-2043
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7402207P00000X, 207R00000X
MTMED-PHYS-LIC-117554207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX74020OtherCALOPTIMA
CA020A74020OtherBLUE SHIELD
CA20A7402OtherBLUE CROSS
CA00AX74020Medicaid
CAH98682Medicare UPIN
CA20A7402OtherBLUE CROSS
CA020A74020OtherBLUE SHIELD