MEDICARE: DR. ANNETTE HULSE D.O.

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	20A12412	CA

General Provider Information

NPI Number	:	1285985820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNETTE HULSE D.O.

Provider Business Mailing Address
First Line	:	1747 KIRCHER CT.
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94024-6208
Country	:	US
Telephone Number	:	650-960-3485
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 1ST ST STE 3
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-2753
Country	:	US
Telephone Number	:	650-960-3485
Fax Number	:

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

Provider Enumeration Date	:	09/23/2012
Last Update Date	:	09/30/2020

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