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NPI Code Detail

MEDICARE: JEANETTE M WHITE HEARING AID SPECIAL

MEDICARE:   JEANETTE M WHITE  HEARING AID SPECIAL
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
1174400000XSpecialistHA0019050CA

General Provider Information

NPI Number : 1235228404
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE M WHITE HEARING AID SPECIAL
Provider Business Mailing Address
First Line : 2975 TREAT BLVD STE B1
Second Line :
City : CONCORD
State : CA
Zip : 94518-3601
Country : US
Telephone Number : 925-288-9500
Fax Number : 925-288-9502
Provider Business Practice Location Address
First Line : 2975 TREAT BLVD
Second Line : SUITE B1
City : CONCORD
State : CA
Zip : 94518-3601
Country : US
Telephone Number : 925-288-9500
Fax Number : 925-288-9502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 12/19/2013

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Directions to “ JEANETTE M WHITE HEARING AID SPECIAL” Practice Location

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