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NPI Code Detail

MEDICARE: MR. PAUL E HENDRICKS RN

MEDICARE:  MR. PAUL E HENDRICKS  RN
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
1163W00000XRegistered Nurse349732CA

General Provider Information

NPI Number : 1124034350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL E HENDRICKS RN
Provider Business Mailing Address
First Line : 651 I ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95814-2400
Country : US
Telephone Number : 916-874-5222
Fax Number :
Provider Business Practice Location Address
First Line : 651 I ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95814-2400
Country : US
Telephone Number : 916-874-5222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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Directions to “ MR. PAUL E HENDRICKS RN” Practice Location

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