Fennel, H Jack
Fennel, H Jack is an individual health care provider with primary practice located at 1031 Washington St , Red Bluff CA 96080. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fennel, H Jack can be contacted via phone (530) 527-2211.Contact Information
Primary practice address
1031 Washington St
Red Bluff CA 96080
Phone: (530) 527-2211
Fax: (530) 527-7412
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5114T | California |
Profile Details
| NPI number | 1962423582 |
|---|---|
| LBN Legal business name | Fennel, H Jack |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Mar 23rd, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962423582 | NPPES |
| California | MEDICAID | SD0051140 |
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