Basic Information
| Provider Information | |||||||||
| NPI: | 1518159300 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A-ADAMS HEARING AID CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3605 ADAMS AVE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921162213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192841014 | ||||||||
| FaxNumber: | 6192844501 | ||||||||
| Practice Location | |||||||||
| Address1: | 3605 ADAMS AVE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921162213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192841014 | ||||||||
| FaxNumber: | 6192844501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2007 | ||||||||
| LastUpdateDate: | 06/13/2008 | ||||||||
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| AuthorizedOfficialLastName: | STEINBERG | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | EMANUEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6192841014 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA0023970 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
ID Information
| ID | Type | State | Issuer | Description | GHA000040 | 05 | CA | MEDICAID |