Healthcare Provider Details

I. General information

NPI: 1194923995
Provider Name (Legal Business Name): PARADISE HEARING & BALANCE CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 CLARK RD
PARADISE CA
95969-5106
US

IV. Provider business mailing address

5500 CLARK RD
PARADISE CA
95969-5106
US

V. Phone/Fax

Practice location:
  • Phone: 530-872-5500
  • Fax: 530-872-7423
Mailing address:
  • Phone: 530-872-5500
  • Fax: 530-872-7423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1853
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA3855
License Number StateCA

VIII. Authorized Official

Name: MR. JOHN P TOUCHETTE
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 530-872-5500