Provider Demographics
NPI:1346414695
Name:D'MORIAS, LINET ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:LINET
Middle Name:ROSE
Last Name:D'MORIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6327 N. FRESNO STREET
Mailing Address - Street 2:SUITE #104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-5236
Mailing Address - Country:US
Mailing Address - Phone:559-431-4020
Mailing Address - Fax:559-431-4589
Practice Address - Street 1:1303 E. HERNDON AVE
Practice Address - Street 2:MAIL STOP 35
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-9860
Practice Address - Country:US
Practice Address - Phone:559-431-4020
Practice Address - Fax:559-431-4589
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48021207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH54316Medicare UPIN
CA00A480210Medicare PIN