Provider Demographics
NPI:1790851772
Name:TIGNER-WEEKES, LINDA I (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:TIGNER-WEEKES
Suffix:I
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 1:853 LAGUNA DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5306
Mailing Address - Country:US
Mailing Address - Phone:213-749-0947
Mailing Address - Fax:213-749-7354
Practice Address - Street 1:515 W 27TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3204
Practice Address - Country:US
Practice Address - Phone:213-749-0947
Practice Address - Fax:213-749-5379
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28464208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics