Provider Demographics
NPI:1366584302
Name:LINDER, EILEEN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARIE
Last Name:LINDER
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 1:4051 LONE TREE WAY
Mailing Address - Street 2:STE E
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-6204
Mailing Address - Country:US
Mailing Address - Phone:925-757-7676
Mailing Address - Fax:925-281-2801
Practice Address - Street 1:4051 LONE TREE WAY
Practice Address - Street 2:SUITE E
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6204
Practice Address - Country:US
Practice Address - Phone:925-757-7676
Practice Address - Fax:925-281-2801
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA09414T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6896Medicaid
CABF529ZMedicare PIN
CAU26988Medicare UPIN
CA6896Medicaid
CABF528AMedicare PIN