Provider Demographics
NPI:1013329168
Name:LINN, NAY
Entity type:Individual
Prefix:
First Name:NAY
Middle Name:
Last Name:LINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 OAKDALE RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3357
Mailing Address - Country:US
Mailing Address - Phone:209-557-6200
Mailing Address - Fax:209-557-6235
Practice Address - Street 1:1225 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3357
Practice Address - Country:US
Practice Address - Phone:209-557-6200
Practice Address - Fax:209-557-6235
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA144680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14015044OtherKAISER NORTHERN CALIFORNIA