Provider Demographics
NPI:1316053309
Name:LUNDEEN, LINDA RAE (MD)
Entity type:Individual
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First Name:LINDA
Middle Name:RAE
Last Name:LUNDEEN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:451 W GONZALES RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-9004
Mailing Address - Country:US
Mailing Address - Phone:804-988-1443
Mailing Address - Fax:805-988-0897
Practice Address - Street 1:1700 N ROSE AVE
Practice Address - Street 2:SUITE 470
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3790
Practice Address - Country:US
Practice Address - Phone:804-988-1443
Practice Address - Fax:805-988-0897
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2016-08-02
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Provider Licenses
StateLicense IDTaxonomies
CAG60123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G601230Medicaid
CA00G601230Medicaid