MEDICARE: MELINDA RUTH VANCE TRUP MS

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	237700000X	Hearing Instrument Specialist	HA2740	CA
2	231H00000X	Audiologist	AU1245	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	640003571	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ54183Z	OTHER	CA	BLUE SHIELD
2	ZZZ56178Z	OTHER	CA	BLUE SHIELD
3	171689100	OTHER	CA	DEPT OF LABOR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982740932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA RUTH VANCE TRUP MS

Provider Business Mailing Address
First Line	:	4748 ENGLE RD STE 107
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-2232
Country	:	US
Telephone Number	:	916-482-2273
Fax Number	:	916-974-2936

Provider Business Practice Location Address
First Line	:	4748 ENGLE RD STE 107
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-2232
Country	:	US
Telephone Number	:	916-482-2273
Fax Number	:	916-974-2936

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	02/16/2024

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Directions to “ MELINDA RUTH VANCE TRUP MS” Practice Location

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