Provider Demographics
NPI:1285785980
Name:SEVILLA, LINDA J (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:SEVILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:15211 VANOWEN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3628
Mailing Address - Country:US
Mailing Address - Phone:818-778-1920
Mailing Address - Fax:818-787-8804
Practice Address - Street 1:15211 VANOWEN ST
Practice Address - Street 2:STE 100
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3628
Practice Address - Country:US
Practice Address - Phone:818-778-1920
Practice Address - Fax:818-787-8804
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69127207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH85313Medicare UPIN