MEDICARE: MICHAEL TRIPLETT BA RDCS

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	246W00000X	Cardiology Technician	RDCS 24327	CA

General Provider Information

NPI Number	:	1952561698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL TRIPLETT BA RDCS

Provider Business Mailing Address
First Line	:	401 WINCHESTER CANYON RD
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93117-1005
Country	:	US
Telephone Number	:	805-680-3784
Fax Number	:	805-685-3715

Provider Business Practice Location Address
First Line	:	401 WINCHESTER CANYON RD
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93117-1005
Country	:	US
Telephone Number	:	805-680-3784
Fax Number	:	805-685-3715

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

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	06/16/2008

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