Healthcare Provider Details

I. General information

NPI: 1699610634
Provider Name (Legal Business Name): CRYSTAL CLEAR HEARING CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 W SUMMER HAVEN LN
LAKESIDE AZ
85929-7082
US

IV. Provider business mailing address

723 W SUMMER HAVEN LN
LAKESIDE AZ
85929-7082
US

V. Phone/Fax

Practice location:
  • Phone: 480-868-9587
  • Fax:
Mailing address:
  • Phone: 480-868-9587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: PETER TRIMBOLI
Title or Position: OWNER
Credential: HADE
Phone: 480-868-9587