Provider Demographics
NPI:1053861211
Name:ROBERTSON, NELTON JOSEPH III (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:MR
First Name:NELTON
Middle Name:JOSEPH
Last Name:ROBERTSON
Suffix:III
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 W 118TH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-2231
Mailing Address - Country:US
Mailing Address - Phone:310-227-6604
Mailing Address - Fax:310-644-7222
Practice Address - Street 1:4477 W 118TH ST STE 403
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2231
Practice Address - Country:US
Practice Address - Phone:310-644-7284
Practice Address - Fax:310-644-7222
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8137237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist