Provider Demographics
NPI:1649540626
Name:PARK, LINDA HANH
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HANH
Last Name:PARK
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 1:20011 BOLLINGER RD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4532
Mailing Address - Country:US
Mailing Address - Phone:408-973-8402
Mailing Address - Fax:408-973-8125
Practice Address - Street 1:20011 BOLLINGER RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-4532
Practice Address - Country:US
Practice Address - Phone:408-973-8402
Practice Address - Fax:408-973-8125
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist