MEDICARE: DON B LOUIE

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	332BX2000X	Oxygen Equipment & Supplies (DME)	10052	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780689430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DON B LOUIE

Provider Business Mailing Address
First Line	:	6051 ENTERPRISE DR
Second Line	:	STE 103
City	:	DIAMOND SPRINGS
State	:	CA
Zip	:	95619-9467
Country	:	US
Telephone Number	:	530-621-2055
Fax Number	:	530-621-2311

Provider Business Practice Location Address
First Line	:	6051 ENTERPRISE DR
Second Line	:	STE 103
City	:	DIAMOND SPRINGS
State	:	CA
Zip	:	95619-9467
Country	:	US
Telephone Number	:	530-621-2055
Fax Number	:	530-621-2311

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DON LOUIE
Credential	:
Telephone Number	:	530-621-2055

Provider Enumeration Date	:	06/19/2005
Last Update Date	:	07/16/2012

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Directions to “DON B LOUIE ” Practice Location

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