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NPI Code Detail

MEDICARE: MRS. ELLIN LOVELESS BC-HIS

MEDICARE: MRS. ELLIN LOVELESS BC-HIS
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
1237700000XHearing Instrument SpecialistHA 1932CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ45183ZOTHERCABS OF CALIFORNIA
2ZZZ71937ZOTHERCAMEDI-CAL PROVIDER

General Provider Information

NPI Number : 1467541532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLIN LOVELESS BC-HIS
Provider Business Mailing Address
First Line : 56970 YUCCA TRL
Second Line : #102
City : YUCCA VALLEY
State : CA
Zip : 92284-3753
Country : US
Telephone Number : 760-365-0691
Fax Number : 760-365-0692
Provider Business Practice Location Address
First Line : 56970 YUCCA TRL
Second Line : #102
City : YUCCA VALLEY
State : CA
Zip : 92284-3753
Country : US
Telephone Number : 760-365-0691
Fax Number : 760-365-0692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. ELLIN LOVELESS BC-HIS” Practice Location

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