Healthcare Provider Details

I. General information

NPI: 1770747552
Provider Name (Legal Business Name): HEARWELL HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 EL CAJON BLVD STE D
SAN DIEGO CA
92115-3900
US

IV. Provider business mailing address

6150 EL CAJON BLVD STE D
SAN DIEGO CA
92115-3928
US

V. Phone/Fax

Practice location:
  • Phone: 619-286-4327
  • Fax: 619-286-4328
Mailing address:
  • Phone: 619-286-4327
  • Fax: 619-286-4328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA2897
License Number StateCA

VIII. Authorized Official

Name: DEBRA LYNN MILLER
Title or Position: PRESIDENT
Credential:
Phone: 619-286-4327