Provider Demographics
NPI:1760894190
Name:LINDA BARKODAR, MD, INC., APC
Entity Type:Organization
Organization Name:LINDA BARKODAR, MD, INC., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKODAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-422-6100
Mailing Address - Street 1:2809 TWEEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-5538
Mailing Address - Country:US
Mailing Address - Phone:323-567-9909
Mailing Address - Fax:323-567-9902
Practice Address - Street 1:2809 TWEEDY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-5538
Practice Address - Country:US
Practice Address - Phone:323-567-9909
Practice Address - Fax:323-567-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107742261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care