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General NPI Number Information
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NPI Number | 1063648707
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Entity Type | Organization
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Legal Business Name | JESTERS HEARING AID CENETR
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Dates
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Enumeration Date | 06/09/2009
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 595 E 6TH ST
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City | BEAUMONT
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State | CA
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Zip | 92223-2217
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Country | US
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Telephone | 951-845-8150
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Fax |
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Provider Business Mailing Address
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Address Line | 595 E 6TH ST
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City | BEAUMONT
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State | CA
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Zip | 92223-2217
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Country | US
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Telephone | 951-845-8150
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Fax |
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Authorized Official
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Title or Position | BC-HIS
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Name | ROBERT JESTER
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Credential |
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Telephone | 951-845-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA1406
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License Number State | CA
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