Provider Demographics
NPI:1326075961
Name:CAHILL, JOHN ARTHUR (MA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ARTHUR
Last Name:CAHILL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FILE #55745
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5745
Mailing Address - Country:US
Mailing Address - Phone:951-849-0432
Mailing Address - Fax:951-849-0432
Practice Address - Street 1:16940 SLOVER AVE STE A
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7566
Practice Address - Country:US
Practice Address - Phone:909-854-8569
Practice Address - Fax:909-854-8558
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1499231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU1499BMedicare PIN
CAWAU1499AMedicare PIN
CAWAU1499CMedicare PIN