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General NPI Number Information
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NPI Number | 1164760575
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Entity Type | Organization
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Legal Business Name | NORTHERN OC ENT PROPERTIES LLC
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Dates
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Enumeration Date | 01/18/2013
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 1955 SUNNYCREST DR STE 108
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City | FULLERTON
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State | CA
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Zip | 92835-3653
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Country | US
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Telephone | 714-441-0133
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Fax | 714-441-1082
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Provider Business Mailing Address
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Address Line | 1955 SUNNYCREST DR STE 108
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City | FULLERTON
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State | CA
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Zip | 92835-3653
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Country | US
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Telephone | 714-441-0133
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Fax | 714-441-1082
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ANN HODGES
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Credential |
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Telephone | 714-441-0133
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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 | 201135710289
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License Number State | CA
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