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General NPI Number Information
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NPI Number | 1386004539
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Entity Type | Organization
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Legal Business Name | CRYSTAL CLEAR HEARING AIDS
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 3855 E LA PALMA AVE STE 116
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City | ANAHEIM
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State | CA
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Zip | 92807-1700
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Country | US
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Telephone | 714-630-7800
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Fax | 714-630-7803
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Provider Business Mailing Address
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Address Line | 3855 E LA PALMA AVE STE 116
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City | ANAHEIM
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State | CA
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Zip | 92807-1700
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Country | US
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Telephone | 714-630-7800
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Fax | 714-630-7803
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Authorized Official
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Title or Position | OWNER/HEARING AID DISPENSER
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Name | MR. DAVID LONGEUAY
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Credential | HEARINGAID DISPENSER
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Telephone | 714-630-7800
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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 | HA8028
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License Number State | CA
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