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NPI Code Detail

MEDICARE: MR. JANS MCCLAIN II RN

MEDICARE: MR. JANS MCCLAIN II RN
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
1163W00000XRegistered Nurse95295616CA

General Provider Information

NPI Number : 1710615885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JANS MCCLAIN II RN
Provider Business Mailing Address
First Line : 620 LANCASTER DR
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-4114
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1350 E GRAND AVE
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-2422
Country : US
Telephone Number : 805-806-5193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2022
Last Update Date : 08/08/2022

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