Provider Demographics
NPI:1104888395
Name:MATSUNAGA, LINDA K (PHARMD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:MATSUNAGA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2179 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8937
Mailing Address - Country:US
Mailing Address - Phone:559-298-1707
Mailing Address - Fax:559-298-4820
Practice Address - Street 1:2179 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-8937
Practice Address - Country:US
Practice Address - Phone:559-298-1707
Practice Address - Fax:559-298-4820
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist