MEDICARE: NANCY DEMARS

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	2471S1302X	Sonography Radiologic Technologist	09006	CA

General Provider Information

NPI Number	:	1396835773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY DEMARS

Provider Business Mailing Address
First Line	:	179 DALMA DR APT 3
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94041-2370
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	179 DALMA DR APT 3
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94041-2370
Country	:	US
Telephone Number	:	650-988-9691
Fax Number	:

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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