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General NPI Number Information
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NPI Number | 1053861211
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Entity Type | Individual
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Provider Name | NELTON JOSEPH ROBERTSON III HEARING AID DISPENSE
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Gender | Male
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 4477 W 118TH ST STE 403
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City | HAWTHORNE
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State | CA
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Zip | 90250-2231
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Country | US
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Telephone | 310-644-7284
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Fax | 310-644-7222
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Provider Business Mailing Address
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Address Line | 4477 W 118TH ST STE 403
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City | HAWTHORNE
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State | CA
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Zip | 90250-2231
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Country | US
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Telephone | 310-227-6604
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Fax | 310-644-7222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA8137
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License Number State | CA
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