Provider Demographics
NPI:1285811349
Name:SONORA HEARING CARE, LLC
Entity type:Organization
Organization Name:SONORA HEARING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:520-881-8740
Mailing Address - Street 1:5625 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2211
Mailing Address - Country:US
Mailing Address - Phone:520-881-8740
Mailing Address - Fax:520-881-0349
Practice Address - Street 1:5625 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2211
Practice Address - Country:US
Practice Address - Phone:520-881-8740
Practice Address - Fax:520-881-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X, 261QH0700X, 332S00000X
AZ0197367261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZNFBHQMedicare UPIN