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General NPI Number Information
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NPI Number | 1578754594
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Entity Type | Organization
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Legal Business Name | REDWOOD COAST HEARING CENTER, INC.
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 785 E WASHINGTON BLVD SUITE 14
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City | CRESCENT CITY
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State | CA
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Zip | 95531-8343
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Country | US
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Telephone | 707-464-7121
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Fax | 707-464-7151
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Provider Business Mailing Address
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Address Line | 785 E WASHINGTON BLVD SUITE 14
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City | CRESCENT CITY
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State | CA
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Zip | 95531-8343
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Country | US
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Telephone | 707-464-7121
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Fax | 707-464-7151
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | DAVID WAYNE GAGER
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Credential | M.S.
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Telephone | 707-464-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | HTL8265
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License Number State | CA
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