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NPI Code Detail

MEDICARE: SUSAN DAVIS-CARR BC HIS 3679

MEDICARE:   SUSAN  DAVIS-CARR  BC HIS 3679
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 SpecialistHIS 3679CA

General Provider Information

NPI Number : 1598144024
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN DAVIS-CARR BC HIS 3679
Provider Business Mailing Address
First Line : 6601 BRIARTREE WAY
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95621-1009
Country : US
Telephone Number : 916-725-0222
Fax Number : 916-910-9979
Provider Business Practice Location Address
First Line : 6601 BRIARTREE WAY
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95621-1009
Country : US
Telephone Number : 916-725-0222
Fax Number : 916-910-9979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2015
Last Update Date : 05/29/2015

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