1386771525 NPI number — HEARING AIDS OF NAPA LLC

Table of content: (NPI 1386771525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386771525 NPI number — HEARING AIDS OF NAPA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARING AIDS OF NAPA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386771525
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3353 BEARD ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94558-3407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-257-3889
Provider Business Mailing Address Fax Number:
707-257-2072

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3353 BEARD ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94558-3407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-257-3889
Provider Business Practice Location Address Fax Number:
707-257-2072
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AGUINALDO CIMOLINO
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
707-257-3889

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  2791 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 171246000 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: HA0027910 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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