Provider Demographics
NPI:1013071869
Name:OLIVER, LINDA (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 MIRAMAR RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-7501
Mailing Address - Country:US
Mailing Address - Phone:858-800-1247
Mailing Address - Fax:858-800-1248
Practice Address - Street 1:9750 MIRAMAR RD STE 180
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-7501
Practice Address - Country:US
Practice Address - Phone:858-800-1247
Practice Address - Fax:858-800-1248
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10949171100000X
CADC28933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU97203Medicare UPIN
CAWDC28933AMedicare ID - Type Unspecified