1487157632 NPI number — MRS. DEBORAH SUZANNE WATKINS HEARING AID SPECIALI

Table of content: MRS. DEBORAH SUZANNE WATKINS HEARING AID SPECIALI (NPI 1487157632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487157632 NPI number — MRS. DEBORAH SUZANNE WATKINS HEARING AID SPECIALI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WATKINS
Provider First Name:
DEBORAH
Provider Middle Name:
SUZANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
HEARING AID SPECIALI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1487157632
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44630 MONTEREY AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM DESERT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92260-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-340-4290
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80150 HWY 111
Provider Second Line Business Practice Location Address:
SUITE C-2
Provider Business Practice Location Address City Name:
INDIO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92201-9220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-863-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  HA8217 , 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)





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