| |
5180 N Fresno St, Suite 102, Fresno, CA 93710-6853 | |
(559) 224-1344 | |
(559) 224-3814 |
Full Name | |
---|---|
Type | Facility |
Speciality | Audiologist-hearing Aid Fitter |
Location | 5180 N Fresno St, Fresno, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740401116 | NPI | - | NPPES |
R22235 | Other | CA | UPIN |
CGP120700 | Other | CA | CCS-MADERA COUNTY |
ZZZ96583Z | Other | CA | RAILROAD MEDI-CARE |
5251815 | Other | CA | MEDI-CAL |
7.33.18 | Medicaid | CA | |
ZZZ75041Z | Medicaid | CA | |
9802919 | Other | CA | CCS-MADERA COUNTY |
ZZZ75041Z | Other | CA | MEDI-CAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | AU244 (California) | Secondary |
237600000X | Audiologist-hearing Aid Fitter | HA1194 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
5180 N Fresno St, Suite 102, Fresno, CA 93710-6853 Ph: (559) 224-1344 | 5180 N Fresno St, Suite 102, Fresno, CA 93710-6853 Ph: (559) 224-1344 |