Austin Puente, IDMT

Individual provider Active NPI Independent Duty Medical Technicians · Edwards, CA

NPI 1184047144 · NPPES record last updated Jan 28, 2014

Key facts

NPI
1184047144
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Medical Technicians 1710I1003X
Practice address
1069 Butler Dr
Edwards, CA 93523-2622
Phone
(832) 465-8000
NPI assigned
Jan 28, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Yes

Addresses

Primary practice location

1069 Butler Dr
Edwards, CA 93523-2622

Mailing address

1069 Butler Dr
Edwards, CA 93523-2622

Other providers in Edwards, CA

All providers in Edwards, CA · Independent Duty Medical Technicians in California

Sources for this page

Verify at the official NPI Registry.