1013923556 NPI number — MS. LINDA SUE COOLEY CATC, RADI

Table of content: MS. LINDA SUE COOLEY CATC, RADI (NPI 1013923556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013923556 NPI number — MS. LINDA SUE COOLEY CATC, RADI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOLEY
Provider First Name:
LINDA
Provider Middle Name:
SUE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CATC, RADI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013923556
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204 S OHIO ST APT A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92805-3697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-620-8131
Provider Business Mailing Address Fax Number:
714-620-8132

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12800 GARDEN GROVE BLVD STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92843-2008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-620-8131
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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