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General NPI Number Information
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NPI Number | 1518105972
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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 | 01/22/2009
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 3088 W RAMSEY ST
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City | BANNING
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State | CA
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Zip | 92220-3724
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Country | US
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Telephone | 951-849-3838
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Fax | 951-849-3880
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Provider Business Mailing Address
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Address Line | 9217 STEPHANIE ST
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City | RIVERSIDE
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State | CA
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Zip | 92508-6271
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Country | US
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Telephone | 951-776-9551
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Fax | 951-849-3880
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Authorized Official
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Title or Position | OWNER
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Name | MR. TRAVIS J BERGMANS
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Credential | AUD
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Telephone | 951-849-3838
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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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