Provider Demographics
NPI:1528246964
Name:NEWPORT AUDIOLOGY CENTERS
Entity type:Organization
Organization Name:NEWPORT AUDIOLOGY CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDILOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:800-782-8585
Mailing Address - Street 1:1600 EAST FLORIDA AVE #312
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544
Mailing Address - Country:US
Mailing Address - Phone:951-652-9143
Mailing Address - Fax:
Practice Address - Street 1:1600 EAST FLORIDA AVE #312
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544
Practice Address - Country:US
Practice Address - Phone:951-652-9143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1140332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment