Provider Demographics
NPI:1770518854
Name:SHER, LINDA SUE (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:SHER
Suffix:
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5908
Mailing Address - Fax:
Practice Address - Street 1:1516 SAN PABLO ST FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-442-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65042204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G560420C29OtherCAL OPTIMA PIN
CA00G65420OtherBLUE SHIELD PIN
CA020048485OtherMEDICARE RAILROAD PIN
CA00G650420Medicaid
CA00G650420Medicaid
CA020048485OtherMEDICARE RAILROAD PIN
CABL961ZMedicare PIN