Provider Demographics
NPI:1124345848
Name:LINNEMANN, GARY ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ARTHUR
Last Name:LINNEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1534 E WARNER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5475
Mailing Address - Country:US
Mailing Address - Phone:714-557-5599
Mailing Address - Fax:714-557-5005
Practice Address - Street 1:1534 E WARNER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5475
Practice Address - Country:US
Practice Address - Phone:714-557-5599
Practice Address - Fax:714-557-5005
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA41712207Q00000X
CAA0417122083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29440OtherNPI ORGANIZATION 1750491221