Healthcare Provider Details

I. General information

NPI: 1053675504
Provider Name (Legal Business Name): MRS. NADINE ELIZABETH PASCUAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 03/24/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1764 ORANGE TREE LN
REDLANDS CA
92374-2856
US

IV. Provider business mailing address

750 N COMMONS DR
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 909-307-8878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA 7726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: