MEDICARE: MS. MAY H BOSCO RDHAP

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	124Q00000X	Dental Hygienist	307	CA

General Provider Information

NPI Number	:	1962709881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAY H BOSCO RDHAP

Provider Business Mailing Address
First Line	:	39 SANTA ANA AVE
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-4236
Country	:	US
Telephone Number	:	650-892-7811
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 SANTA ANA AVE
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-4253
Country	:	US
Telephone Number	:	650-892-7811
Fax Number	:

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

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	11/21/2014

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