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NPI Code Detail

MEDICARE: ERIC DYSON HIS

MEDICARE:   ERIC  DYSON  HIS
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
1237700000XHearing Instrument Specialist9562CA
2237700000XHearing Instrument SpecialistF03563PA

General Provider Information

NPI Number : 1417354135
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC DYSON HIS
Provider Business Mailing Address
First Line : 750 N COMMONS DR STE 200
Second Line :
City : AURORA
State : IL
Zip : 60504-7940
Country : US
Telephone Number : 630-303-5380
Fax Number : 630-303-5385
Provider Business Practice Location Address
First Line : 12062 VALLEY VIEW ST STE 100
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92845-1738
Country : US
Telephone Number : 714-893-6790
Fax Number : 714-893-6904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2014
Last Update Date : 03/08/2021

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Directions to “ ERIC DYSON HIS” Practice Location

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