Provider Demographics
NPI:1902248289
Name:OKAMOTO, LINDA KHAW (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:KHAW
Last Name:OKAMOTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 HICKEY BLVD FL 4
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:395 HICKEY BLVD FL 4
Practice Address - Street 2:4TH FLOOR
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2770
Practice Address - Country:US
Practice Address - Phone:650-301-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine