MEDICARE: NORTH STATE PULMONARY FUNCTION LABORATORY

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	225B00000X	Pulmonary Function Technologist	RCP3176	CA

General Provider Information

NPI Number	:	1174771059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH STATE PULMONARY FUNCTION LABORATORY

Provider Business Mailing Address
First Line	:	130 INDEPENDENCE CIR
Second Line	:	SUITE 1
City	:	CHICO
State	:	CA
Zip	:	95973-4962
Country	:	US
Telephone Number	:	530-343-5864
Fax Number	:	530-343-8370

Provider Business Practice Location Address
First Line	:	130 INDEPENDENCE CIR
Second Line	:	SUITE 1
City	:	CHICO
State	:	CA
Zip	:	95973-4962
Country	:	US
Telephone Number	:	530-343-5864
Fax Number	:	530-343-8370

Authorized Official
Title or Position	:	PARTNER
Name	:	NORMAN P HOWELL
Credential	:	RCP
Telephone Number	:	530-343-5864

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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