Healthcare Provider Details

I. General information

NPI: 1265608319
Provider Name (Legal Business Name): HEAR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E DEL MAR BLVD
PASADENA CA
91101-2714
US

IV. Provider business mailing address

301 E DEL MAR BLVD
PASADENA CA
91101-2714
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-2016
  • Fax: 626-796-2320
Mailing address:
  • Phone: 626-796-2016
  • Fax: 626-796-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAU640
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number640
License Number StateCA

VIII. Authorized Official

Name: MRS. ELLEN SHAPIRO SIMON
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 626-796-2016