Healthcare Provider Details

I. General information

NPI: 1972757045
Provider Name (Legal Business Name): HILLCREST HEARING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2008
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 3RD AVE SUITE 104
SAN DIEGO CA
92103-2117
US

IV. Provider business mailing address

4033 3RD AVE SUITE 104
SAN DIEGO CA
92103-2117
US

V. Phone/Fax

Practice location:
  • Phone: 619-294-2038
  • Fax: 619-294-2038
Mailing address:
  • Phone: 619-294-2038
  • Fax: 619-294-2038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1055
License Number StateCA

VIII. Authorized Official

Name: SUSAN PERRY
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 619-294-2038