Healthcare Provider Details

I. General information

NPI: 1366524936
Provider Name (Legal Business Name): TEMECULA HEARING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27349 JEFFERSON AVE #112
TEMECULA CA
92590-5634
US

IV. Provider business mailing address

27349 JEFFERSON AVE #112
TEMECULA CA
92590-5634
US

V. Phone/Fax

Practice location:
  • Phone: 951-296-5690
  • Fax: 951-296-5693
Mailing address:
  • Phone: 951-296-5690
  • Fax: 951-296-5693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU968
License Number StateCA

VIII. Authorized Official

Name: MR. MICHAEL FRANCIS STEJKAL
Title or Position: AUDIOLOGIST
Credential: M.S., CCC-A
Phone: 951-296-5690