MEDICARE: MR. NOAH DIEGO GARCIA

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	237700000X	Hearing Instrument Specialist	115640	IA

General Provider Information

NPI Number	:	1558140038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NOAH DIEGO GARCIA

Provider Business Mailing Address
First Line	:	1010 S GRAND AVE STE 2
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-3729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 S GRAND AVE STE 2
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-3729
Country	:	US
Telephone Number	:	641-450-1258
Fax Number	:

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

Provider Enumeration Date	:	09/25/2023
Last Update Date	:	09/25/2023

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