MEDICARE: MEUY TSOON SAECHAO FNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	FNP21795	CA

General Provider Information

NPI Number	:	1558615369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEUY TSOON SAECHAO FNP

Provider Business Mailing Address
First Line	:	PO BOX 496084
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96049-6084
Country	:	US
Telephone Number	:	530-225-8500
Fax Number	:	530-246-4000

Provider Business Practice Location Address
First Line	:	1842 BUENAVENTURA BLVD
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-3700
Country	:	US
Telephone Number	:	530-225-8500
Fax Number	:	530-246-4000

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

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	10/31/2012

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