Healthcare Provider Details

I. General information

NPI: 1578600086
Provider Name (Legal Business Name): HEAR WELL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 LONG BEACH BLVD STE 110
LONG BEACH CA
90807-4013
US

IV. Provider business mailing address

3605 LONG BEACH BLVD STE 110
LONG BEACH CA
90807-4013
US

V. Phone/Fax

Practice location:
  • Phone: 562-989-8101
  • Fax: 562-989-8119
Mailing address:
  • Phone: 562-989-8101
  • Fax: 562-989-8119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1232
License Number StateCA

VIII. Authorized Official

Name: STEPHEN MARTINEZ
Title or Position: OWNER OF THE HEAR WELL CENTER
Credential: AU.D.,PH.D.
Phone: 562-989-8101