Provider Demographics
NPI:1356503502
Name:E PAUL DIETSCH HEARING AIDS INC
Entity type:Organization
Organization Name:E PAUL DIETSCH HEARING AIDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETSCH
Authorized Official - Suffix:
Authorized Official - Credentials:HA499
Authorized Official - Phone:619-297-4145
Mailing Address - Street 1:689 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4009
Mailing Address - Country:US
Mailing Address - Phone:619-579-8455
Mailing Address - Fax:
Practice Address - Street 1:689 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4009
Practice Address - Country:US
Practice Address - Phone:619-579-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA499237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78218ZMedicaid