MEDICARE: DR. RAYMOND SPLINTER M.D.

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	174400000X	Specialist	C37661	CA

General Provider Information

NPI Number	:	1194854695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND SPLINTER M.D.

Provider Business Mailing Address
First Line	:	8415 GRANT AVE
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5303
Country	:	US
Telephone Number	:	619-460-2672
Fax Number	:

Provider Business Practice Location Address
First Line	:	8415 GRANT AVE
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5303
Country	:	US
Telephone Number	:	619-460-2672
Fax Number	:

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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