Basic Information
| Provider Information | |||||||||
| NPI: | 1124233655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICHARDSON QUALITY HEARING AID CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 E LATHAM AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925434435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519259948 | ||||||||
| FaxNumber: | 9519258333 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 E LATHAM AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925434435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519259948 | ||||||||
| FaxNumber: | 9519258333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RICHARDSON | ||||||||
| AuthorizedOfficialFirstName: | DOROTHY | ||||||||
| AuthorizedOfficialMiddleName: | MAE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9519259948 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | HEARING SPECIALIST | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA2836 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.