Provider Demographics
NPI:1750491221
Name:GARY A. LINNEMANN, MD, INC.
Entity Type:Organization
Organization Name:GARY A. LINNEMANN, MD, INC.
Other - Org Name:PACIFIC MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINNEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-557-5599
Mailing Address - Street 1:1534 E WARNER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5475
Mailing Address - Country:US
Mailing Address - Phone:714-557-5599
Mailing Address - Fax:714-557-5005
Practice Address - Street 1:1534 E WARNER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5475
Practice Address - Country:US
Practice Address - Phone:714-557-5599
Practice Address - Fax:714-557-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41712207QA0505X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty