MEDICARE: JAZZY BEAR, LLC

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1033910542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAZZY BEAR, LLC

Provider Business Mailing Address
First Line	:	1096 DUMAS LN
Second Line	:
City	:	BIG BEAR CITY
State	:	CA
Zip	:	92314-9524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1096 DUMAS LN
Second Line	:
City	:	BIG BEAR CITY
State	:	CA
Zip	:	92314-9524
Country	:	US
Telephone Number	:	909-375-6799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAZMIN DELANEY
Credential	:
Telephone Number	:	858-822-8097

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	03/20/2025

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Directions to “JAZZY BEAR, LLC ” Practice Location

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