Organization
LINDA MAK, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA L MAK MD (DR)
(760) 353-0574
Entity
Organization
Contact information
Practice address
1745 S IMPERIAL AVE, EL CENTRO, CA 92243-4243
(760) 353-0574
(760) 353-0397
Mailing address
PO BOX 2678, EL CENTRO, CA 92244-2678
(760) 353-0574
(760) 353-0397
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W15903
MEDICARE PROVIDER
CA
Enumeration date
06/25/2006
Last updated
11/12/2007
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