Healthcare Provider Details

I. General information

NPI: 1619909165
Provider Name (Legal Business Name): RANCHO BERNARDO HEARING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16766 BERNARDO CENTER DR SUITE 206
SAN DIEGO CA
92128-2545
US

IV. Provider business mailing address

16766 BERNARDO CENTER DR SUITE 206
SAN DIEGO CA
92128-2545
US

V. Phone/Fax

Practice location:
  • Phone: 858-485-0909
  • Fax: 858-485-0930
Mailing address:
  • Phone: 858-485-0909
  • Fax: 858-485-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAU78
License Number StateCA

VIII. Authorized Official

Name: DR. JUDITH K. HORNING
Title or Position: PRESIDENT/CEO
Credential: AU.D.
Phone: 858-485-0909