Provider Demographics
NPI:1215061221
Name:JOHNSON AND JOHNSON HEARING AID CENTER
Entity type:Organization
Organization Name:JOHNSON AND JOHNSON HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-672-4940
Mailing Address - Street 1:26916 CHERRY HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2574
Mailing Address - Country:US
Mailing Address - Phone:951-672-4940
Mailing Address - Fax:951-672-7631
Practice Address - Street 1:26916 CHERRY HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2574
Practice Address - Country:US
Practice Address - Phone:951-672-4940
Practice Address - Fax:951-672-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3515174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA611390800OtherUS DEPT OF LABOR