Healthcare Provider Details

I. General information

NPI: 1578972782
Provider Name (Legal Business Name): HILLCREST HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAU1812
License Number StateCA

VIII. Authorized Official

Name: MR. STEPHEN PERRY
Title or Position: OWNER
Credential:
Phone: 619-294-2038