Provider Demographics
NPI:1154433217
Name:FOSTER, LINDA L (OD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 EAGLE ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1906
Mailing Address - Country:US
Mailing Address - Phone:323-255-2221
Mailing Address - Fax:888-741-7962
Practice Address - Street 1:4921 EAGLE ROCK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1906
Practice Address - Country:US
Practice Address - Phone:323-255-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10488T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGI915AMedicare PIN
CAU63690Medicare UPIN