MEDICARE: DR. KJARTAN DEAN ARMANN MD

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	2080A0000X	Pediatric Adolescent Medicine Physician	A41413	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A414130	OTHER	CA	BS

General Provider Information

NPI Number	:	1619922887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KJARTAN DEAN ARMANN MD

Provider Business Mailing Address
First Line	:	2516 SAMARITAN DRIVE
Second Line	:	SUITE J
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4108
Country	:	US
Telephone Number	:	408-356-0578
Fax Number	:	408-356-3986

Provider Business Practice Location Address
First Line	:	2516 SAMARITAN DRIVE
Second Line	:	SUITE J
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4108
Country	:	US
Telephone Number	:	408-356-0578
Fax Number	:	408-356-3986

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/26/2011

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