MEDICARE: HOPE H EWING MD

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	207Q00000X	Family Medicine Physician	G36227	CA

General Provider Information

NPI Number	:	1700863081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE H EWING MD

Provider Business Mailing Address
First Line	:	PO BOX 535
Second Line	:	18144 SECO ST.
City	:	JAMESTOWN
State	:	CA
Zip	:	95327-0535
Country	:	US
Telephone Number	:	208-984-4820
Fax Number	:	209-984-4825

Provider Business Practice Location Address
First Line	:	18144 SECO STREET
Second Line	:
City	:	JAMESTOWN
State	:	CA
Zip	:	95327-9737
Country	:	US
Telephone Number	:	208-984-4820
Fax Number	:	209-984-4825

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/06/2008

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