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Individual
PETER JANSEN MARINCOVICH
Active
Individual
PETER JANSEN MARINCOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD AUDIOLOGIST DISP
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU758
CA
237600000X
Audiologist-Hearing Aid Fitter
HA1949
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
640002077
RRM
CA
05
—
AU0007580
—
CA
01
—
ZZZ03361Z
BLUE SHIELD
CA
01
—
ZZZ03362Z
BLUE SHIELD
CA
Enumeration date
11/30/2006
Last updated
03/13/2013
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