MEDICARE: DR. NOBUKO M ITO AU.D.

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	231H00000X	Audiologist	AU1661	CA
2	231HA2400X	Assistive Technology Practitioner Audiologist	AU1661	CA
3	231HA2500X	Assistive Technology Supplier Audiologist	AU1661	CA
4	237600000X	Audiologist-Hearing Aid Fitter	AU1661	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700930393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOBUKO M ITO AU.D.

Provider Business Mailing Address
First Line	:	467 SARATOGA AVE STE 170
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-1326
Country	:	US
Telephone Number	:	408-891-1476
Fax Number	:

Provider Business Practice Location Address
First Line	:	467 SARATOGA AVE STE 170
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-1326
Country	:	US
Telephone Number	:	408-891-1476
Fax Number	:

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	03/14/2025

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