MEDICARE: LILLIAN T WATT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332S00000X	Hearing Aid Equipment	HA9247	CA
2	237700000X	Hearing Instrument Specialist	HA9247	CA

General Provider Information

NPI Number	:	1467391292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIAN T WATT

Provider Business Mailing Address
First Line	:	2557 MOWRY AVE STE 31
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1614
Country	:	US
Telephone Number	:	510-745-0900
Fax Number	:	510-745-0901

Provider Business Practice Location Address
First Line	:	2557 MOWRY AVE STE 31
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1614
Country	:	US
Telephone Number	:	510-745-0900
Fax Number	:	510-745-0901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “ LILLIAN T WATT ” Practice Location

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