Jesse Revin Situmeang, is a
Licensed Vocational Nurse based in 29 Palms, California. Jesse Revin Situmeang is licensed to practice in California (license number 243146) and his current practice location is
71952 Buena Vista Dr, 29 Palms, California. He can be reached at his office (for appointments etc.) via phone at
(720) 666-0999.
NPI number for Jesse Revin Situmeang is 1164166492 and his current mailing address is 71952 Buena Vista Dr, 29 Palms, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164166492.
Provider's Profile
Full Name | Jesse Revin Situmeang |
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Gender | Male |
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Speciality | Licensed Vocational Nurse |
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Location | 71952 Buena Vista Dr, 29 Palms, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164166492
- Provider Enumeration Date: 04/22/2022
- Last Update Date: 04/22/2022
Medical Identifiers
Medical identifiers for Jesse Revin Situmeang such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164166492 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164X00000X | Licensed Vocational Nurse | 243146 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jesse Revin Situmeang is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jesse Revin Situmeang, 71952 Buena Vista Dr, 29 Palms, CA 92277-2076 Ph: (720) 666-0999 | Jesse Revin Situmeang, 71952 Buena Vista Dr, 29 Palms, CA 92277-2076 Ph: (720) 666-0999 |
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