Provider Demographics
NPI:1073611406
Name:CALIFORNIA EAR INSTITUTE, INC.
Entity Type:Organization
Organization Name:CALIFORNIA EAR INSTITUTE, INC.
Other - Org Name:CALIFORNIA EAR INSTITUTE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BAXTER
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:650-462-3149
Mailing Address - Street 1:1900 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2213
Mailing Address - Country:US
Mailing Address - Phone:650-494-1000
Mailing Address - Fax:650-322-8228
Practice Address - Street 1:1900 UNIVERSITY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-2213
Practice Address - Country:US
Practice Address - Phone:650-494-1000
Practice Address - Fax:650-322-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC24575174400000X
CAA53869174400000X
CAG65997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZB2034ZMedicare PIN