Provider Demographics
NPI:1285758524
Name:CHRISTENSEN HEARING CENTER
Entity type:Organization
Organization Name:CHRISTENSEN HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:909-392-0302
Mailing Address - Street 1:175 W LA VERNE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2347
Mailing Address - Country:US
Mailing Address - Phone:909-392-0302
Mailing Address - Fax:909-392-0216
Practice Address - Street 1:175 W LA VERNE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2347
Practice Address - Country:US
Practice Address - Phone:909-392-0302
Practice Address - Fax:909-392-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2036174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty