Basic Information
| Provider Information | |||||||||
| NPI: | 1992888788 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTER FOR BETTER HEARING, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | CENTER FOR BETTER HEARING AIDS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 190 EL CERRITO PLZ | ||||||||
| Address2: | |||||||||
| City: | EL CERRITO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945304002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105263824 | ||||||||
| FaxNumber: | 5105263764 | ||||||||
| Practice Location | |||||||||
| Address1: | 190 EL CERRITO PLZ | ||||||||
| Address2: | |||||||||
| City: | EL CERRITO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945304002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105263824 | ||||||||
| FaxNumber: | 5105263764 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 04/23/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FREE | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | PHILIP | ||||||||
| AuthorizedOfficialTitleorPosition: | HEARING AID DISPENSER | ||||||||
| AuthorizedOfficialTelephone: | 5105263824 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | HA3689 | CA | N | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | 332S00000X | Y | Suppliers | Hearing Aid Equipment |
ID Information
| ID | Type | State | Issuer | Description | HA0036890 | 01 | CA | MEDI-CAL | OTHER |