MEDICARE: AT2J ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QH0700X	Hearing and Speech Clinic/Center
2	332S00000X	Hearing Aid Equipment
3	231H00000X	Audiologist

General Provider Information

NPI Number	:	1730571332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT2J ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	1717 SIMI TOWN CENTER WAY STE 3
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-8408
Country	:	US
Telephone Number	:	805-579-9324
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 SIMI TOWN CENTER WAY STE 3
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-8408
Country	:	US
Telephone Number	:	805-579-9324
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN MALAN
Credential	:
Telephone Number	:	805-579-9324

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	12/19/2019

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