Provider Demographics
NPI:1962405464
Name:MYERS, LINDA-LEE (MD)
Entity type:Individual
Prefix:
First Name:LINDA-LEE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28009 MERCURIO RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8429
Mailing Address - Country:US
Mailing Address - Phone:831-625-3363
Mailing Address - Fax:
Practice Address - Street 1:23845 HOLMAN HWY
Practice Address - Street 2:SUITE 318
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5900
Practice Address - Country:US
Practice Address - Phone:831-625-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAO67468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20507Medicare UPIN
00A674682Medicare PIN