Healthcare Provider Details

I. General information

NPI: 1275894933
Provider Name (Legal Business Name): JULIAN PIERROT HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 FLORIN ROAD 60
SACRAMENTO CA
95823-2523
US

IV. Provider business mailing address

4241 FLORIN RD 60 FLORIN HEARING CENTER
SACRAMENTO CA
95823-2325
US

V. Phone/Fax

Practice location:
  • Phone: 916-421-5002
  • Fax:
Mailing address:
  • Phone: 916-421-5002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA 7298
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: