Healthcare Provider Details

I. General information

NPI: 1487949145
Provider Name (Legal Business Name): DANIEL A COBB BC-HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E HORIZON DR SUITE D
HENDERSON NV
89015
US

IV. Provider business mailing address

220 E HORIZON DR. SUITE D
HENDERSON NV
89015
US

V. Phone/Fax

Practice location:
  • Phone: 702-949-0993
  • Fax: 360-882-7979
Mailing address:
  • Phone: 702-949-0993
  • Fax: 360-882-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-P-358143
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA 60222085
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: