Provider Demographics
NPI:1013918911
Name:TOMLIN, LUELINDA (OD)
Entity Type:Individual
Prefix:
First Name:LUELINDA
Middle Name:
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 E LOS COYOTES DIAGONAL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2820
Mailing Address - Country:US
Mailing Address - Phone:562-437-1276
Mailing Address - Fax:562-494-3388
Practice Address - Street 1:4409 E LOS COYOTES DIAGONAL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2820
Practice Address - Country:US
Practice Address - Phone:562-437-1276
Practice Address - Fax:562-494-3388
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8170T152W00000X
CAOP8170T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013918911OtherMEDICARE
CASD0081700Medicaid
CASD0081700OtherBLUE SHIELD
CA330442849OtherBLUE CROSS
CA330442849OtherBLUE CROSS
CASD0081700Medicaid