MEDICARE: JOHNSON AND JOHNSON HEARING AID CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	HA3515	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	611390800	OTHER	CA	US DEPT OF LABOR

General Provider Information

NPI Number	:	1215061221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON AND JOHNSON HEARING AID CENTER

Provider Business Mailing Address
First Line	:	26916 CHERRY HILLS BLVD
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92586-2574
Country	:	US
Telephone Number	:	951-672-4940
Fax Number	:	951-672-7631

Provider Business Practice Location Address
First Line	:	26916 CHERRY HILLS BLVD
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92586-2574
Country	:	US
Telephone Number	:	951-672-4940
Fax Number	:	951-672-7631

Authorized Official
Title or Position	:	HEARING INSTRUMENT SPECIALIST
Name	:	MR. MIKE JOHNSON
Credential	:
Telephone Number	:	951-672-4940

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	04/05/2011

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