MEDICARE: BELLOWS HEARING INSTITUTE, LLC

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	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1861827073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLOWS HEARING INSTITUTE, LLC

Provider Business Mailing Address
First Line	:	74133 EL PASEO STE 6
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4122
Country	:	US
Telephone Number	:	760-340-6494
Fax Number	:	760-568-1235

Provider Business Practice Location Address
First Line	:	74133 EL PASEO STE 6
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4122
Country	:	US
Telephone Number	:	760-340-6494
Fax Number	:	760-568-1235

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LIZ NATHAN BELLOWS
Credential	:	M.A. C.C.C.A.
Telephone Number	:	760-340-6494

Provider Enumeration Date	:	09/06/2013
Last Update Date	:	01/31/2020

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