Healthcare Provider Details

I. General information

NPI: 1659908606
Provider Name (Legal Business Name): TIMOTHY OMEARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 EL CAMINO REAL STE 105
CARLSBAD CA
92008-2194
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 760-729-7800
  • Fax: 760-729-7878
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number8960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: