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General NPI Number Information
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NPI Number | 1194963587
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Entity Type | Organization
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Legal Business Name | ALL EARS HEARING CENTER
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 621 W. LINE ST. SUITE 102
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City | BISHOP
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State | CA
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Zip | 93514
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Country | US
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Telephone | 760-873-8848
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Fax | 760-873-9900
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Provider Business Mailing Address
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Address Line | 621 W. LINE ST. SUITE 102
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City | BISHOP
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State | CA
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Zip | 93514
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Country | US
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Telephone | 760-873-8848
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Fax | 760-873-9900
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Authorized Official
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Title or Position | OWNER
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Name | TRAVIS J BERGMANS
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Credential | AUD FAAA
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Telephone | 760-873-8848
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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 | 7224
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2322
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU2322
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License Number State | CA
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