Basic Information
| Provider Information | |||||||||
| NPI: | 1386730588 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A-ADAMS HEARING AID CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3605 ADAMS AVENUE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921162213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192841014 | ||||||||
| FaxNumber: | 6192844501 | ||||||||
| Practice Location | |||||||||
| Address1: | 3605 ADAMS AVENUE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921162213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192841014 | ||||||||
| FaxNumber: | 6192844501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 06/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | STEINBERG | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6192841014 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | LIC HEARING AID SPEC | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA2397 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
ID Information
| ID | Type | State | Issuer | Description | HA0023970 | 05 | CA | MEDICAID |