1700874161 NPI number — LILIAN ESTRADA-LINDER MD

Table of content: LILIAN ESTRADA-LINDER MD (NPI 1700874161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700874161 NPI number — LILIAN ESTRADA-LINDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESTRADA-LINDER
Provider First Name:
LILIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1700874161
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
441 N LAKEVIEW AVE
Provider Second Line Business Mailing Address:
KAISER PERMANENTE , MEDICAL STAFF OFFICE 8TH FLOOR
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92807-3028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-279-4130
Provider Business Mailing Address Fax Number:
714-279-4029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
441 N LAKEVIEW AVE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92807-3028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-279-5879
Provider Business Practice Location Address Fax Number:
714-279-4029
Provider Enumeration Date:
10/10/2005

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: 208600000X , with the licence number:  9515 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: XPY193994 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002016891 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: CC0460 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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