Provider Demographics
NPI:1003101106
Name:MAUR, JEFFREY (CRT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MAUR
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 1/2 OPAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92662-2008
Mailing Address - Country:US
Mailing Address - Phone:949-637-6867
Mailing Address - Fax:
Practice Address - Street 1:131 1/2 OPAL AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92662-2008
Practice Address - Country:US
Practice Address - Phone:949-637-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31011227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified