MEDICARE: MRS. ESTELA VARGAS

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	2355A2700X	Audiology Assistant
2	237700000X	Hearing Instrument Specialist	HA7567	CA

General Provider Information

NPI Number	:	1013217058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESTELA VARGAS

Provider Business Mailing Address
First Line	:	200 JOSE FIGUERES AVE STE 280
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1555
Country	:	US
Telephone Number	:	408-937-8900
Fax Number	:	408-937-8902

Provider Business Practice Location Address
First Line	:	200 JOSE FIGUERES AVE STE 280
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1555
Country	:	US
Telephone Number	:	408-937-8900
Fax Number	:	408-937-8902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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