Provider Demographics
NPI:1154649119
Name:PENINSULA HEARING CENTER, INC
Entity type:Organization
Organization Name:PENINSULA HEARING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RISO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:619-756-7848
Mailing Address - Street 1:1310 ROSECRANS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2643
Mailing Address - Country:US
Mailing Address - Phone:619-756-7848
Mailing Address - Fax:619-564-7056
Practice Address - Street 1:1310 ROSECRANS ST
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2643
Practice Address - Country:US
Practice Address - Phone:619-756-7848
Practice Address - Fax:619-564-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment