Healthcare Provider Details

I. General information

NPI: 1356503502
Provider Name (Legal Business Name): E PAUL DIETSCH HEARING AIDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 E MAIN ST
EL CAJON CA
92020-4009
US

IV. Provider business mailing address

689 E MAIN ST
EL CAJON CA
92020-4009
US

V. Phone/Fax

Practice location:
  • Phone: 619-579-8455
  • Fax:
Mailing address:
  • Phone: 619-579-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA499
License Number StateCA

VIII. Authorized Official

Name: MS. MONICA DIETSCH
Title or Position: PRESIDENT
Credential: HA499
Phone: 619-297-4145