Trung Ha Quach, AT

Individual provider Active NPI Health Educator · Mountain House, CA

NPI 1700243763 · NPPES record last updated Jan 21, 2016

Key facts

NPI
1700243763
Entity type
Individual (NPI type 1)
Primary specialty
Health Educator 174H00000X
License
NBC-22621 (CA)
Practice address
63 W Posada LN
Mountain House, CA 95391-2041
Phone
(209) 817-3735
NPI assigned
Jan 21, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NBC-22621CAMDHealth Educator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X NBC-22621 CA Yes

Addresses

Primary practice location

63 W Posada LN
Mountain House, CA 95391-2041

Mailing address

63 W Posada Lane
Mountain House, CA 95391
Phone (209) 817-3735

Other providers in Mountain House, CA

All providers in Mountain House, CA · Health Educator in California

Sources for this page

Verify at the official NPI Registry.