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General NPI Number Information
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NPI Number | 1780820464
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Entity Type | Organization
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Legal Business Name | SHIBUMI ACQUISITION LLC
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 6500 COYLE AVE SUITE 1
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City | CARMICHAEL
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State | CA
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Zip | 95608-0301
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Country | US
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Telephone | 916-961-0754
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Fax | 916-961-9775
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Provider Business Mailing Address
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Address Line | 6500 COYLE AVE SUITE 1
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City | CARMICHAEL
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State | CA
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Zip | 95608-0301
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Country | US
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Telephone | 916-961-0754
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Fax | 916-961-9775
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. TOD BORGES
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Credential |
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Telephone | 916-961-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA3827
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License Number State | CA
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