Provider Demographics
NPI:1093924573
Name:GREENLEY OAKS HEARING RESOURCE CENTER, INC.
Entity Type:Organization
Organization Name:GREENLEY OAKS HEARING RESOURCE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:209-588-0662
Mailing Address - Street 1:795 MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5193
Mailing Address - Country:US
Mailing Address - Phone:209-588-0662
Mailing Address - Fax:209-588-0664
Practice Address - Street 1:795 MORNING STAR DR
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5193
Practice Address - Country:US
Practice Address - Phone:209-588-0662
Practice Address - Fax:209-588-0664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU117231H00000X
CAAU2224237600000X
CAHA4108237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty