Healthcare Provider Details
I. General information
NPI: 1376637272
Provider Name (Legal Business Name): PHYSICIANS HEARING AID CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 WATER ST STE A
SANTA CRUZ CA
95060-4126
US
IV. Provider business mailing address
550 WATER ST STE A
SANTA CRUZ CA
95060-4126
US
V. Phone/Fax
- Phone: 831-476-4414
- Fax: 831-462-8262
- Phone: 831-476-4414
- Fax: 831-462-8262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | SRYGHD097689968 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DANIEL
A
SPILMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 831-462-8260