Organization Active NPI

Mark S Linam DPM a Professional Corp.

  • Foot & Ankle Surgery Podiatrist
  • Norwalk, CA
National Provider Identifier
1508917204
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3500 Issued in CA
Legal business name
MARK S LINAM DPM A PROFESSIONAL CORP.
Practice address
12820 Studebaker Rd Ste 200
Norwalk, CA 90650-2583
Phone
(562) 868-0787
Fax
(562) 375-6188
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark Scott Linam, DPMNPI 1811161771
Title
Podiatristsurgeon
Phone
(562) 868-0787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E3500 CA Primary

Addresses

Primary practice location

12820 Studebaker Rd Ste 200
Norwalk, CA 90650-2583

Mailing address

PO Box 1204
Norwalk, CA 90651-1204
Phone (562) 868-0787

Other identifiers 1

IdentifierTypeStateIssuer
000E35000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930081996 CA DME Supplier - Physician - Podiatry 4183824758 1 other NPI on this enrollment
Practice locations: Paramount, CA
O20140603001561 CA Part B Supplier - Clinic/Group Practice 4183824758 Receives reassigned benefits from 2 practitioners
Practice locations: Paramount, CA; San Francisco, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12556 Valley View St
Garden Grove, CA 92845
Phone (714) 897-9355

16660 Paramount Blvd
Ste 101
Paramount, CA 90723
Phone (562) 633-0976

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1508917204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1204",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906511204",
            "telephone_number": "562-868-0787",
            "fax_number": "562-375-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12820 STUDEBAKER RD STE 200",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502583",
            "telephone_number": "562-868-0787",
            "fax_number": "562-375-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S LINAM DPM A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "LINAM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PODIATRISTSURGEON",
        "authorized_official_telephone_number": "562-868-0787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E35000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.