Provider Demographics
NPI:1760458533
Name:AOYAMA, LINDA E (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:E
Last Name:AOYAMA
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 1:988 S FAIR OAKS AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2626
Mailing Address - Country:US
Mailing Address - Phone:626-799-4193
Mailing Address - Fax:
Practice Address - Street 1:988 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2626
Practice Address - Country:US
Practice Address - Phone:626-799-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65993207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH04380Medicare UPIN