Provider Demographics
NPI:1902889231
Name:MCDONALD, LINN SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:LINN
Middle Name:SCOTT
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2703
Mailing Address - Country:US
Mailing Address - Phone:909-594-5243
Mailing Address - Fax:909-594-5374
Practice Address - Street 1:302 S LEMON AVE
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2703
Practice Address - Country:US
Practice Address - Phone:909-594-5243
Practice Address - Fax:909-594-5374
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14439111NI0013X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATO5377Medicare ID - Type Unspecified