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NPI Code Detail

MEDICARE: SEAN HEMBRE CP

MEDICARE: SEAN HEMBRE CP
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
1224P00000XProsthetist

General Provider Information

NPI Number : 1871853564
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN HEMBRE CP
Provider Business Mailing Address
First Line : 3663 N LAUGHLIN RD STE 103
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-9067
Country : US
Telephone Number : 707-528-7999
Fax Number :
Provider Business Practice Location Address
First Line : 3663 N LAUGHLIN RD STE 103
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-9067
Country : US
Telephone Number : 707-528-7999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2012
Last Update Date : 05/29/2012

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Directions to “ SEAN HEMBRE CP” Practice Location

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