Basic Information
Provider Information
NPI: 1083087902
EntityType: 2
ReplacementNPI:  
OrganizationName: AURALCARE HEARING CENTERS OF AMERICA, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MY HEARING CENTERS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8941 S 700 E STE 204
Address2:  
City: SANDY
State: UT
PostalCode: 840702402
CountryCode: US
TelephoneNumber: 8018498497
FaxNumber:  
Practice Location
Address1: 27201 TOURNEY RD STE 123
Address2:  
City: VALENCIA
State: CA
PostalCode: 913551801
CountryCode: US
TelephoneNumber: 6618881302
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2015
LastUpdateDate: 12/01/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LARSEN
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8018498497
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QH0700X  Y Ambulatory Health Care FacilitiesClinic/CenterHearing and Speech

No ID Information.


Home