Healthcare Provider Details

I. General information

NPI: 1679864227
Provider Name (Legal Business Name): HEARWELL AUDIOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14911 NATIONAL AVE #2
LOS GATOS CA
95032
US

IV. Provider business mailing address

14911 NATIONAL AVE SUITE 2
LOS GATOS CA
95032-2632
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-1999
  • Fax: 408-356-1988
Mailing address:
  • Phone: 408-356-1999
  • Fax: 408-356-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU727
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU883
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU484
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU455
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU2720
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JOHN C. MILES
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 408-356-1999