Provider Demographics
NPI:1467918433
Name:YOUR HEARING CONNECTION AN AUDIOLOGY CORPORATION
Entity Type:Organization
Organization Name:YOUR HEARING CONNECTION AN AUDIOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:BREJCHA
Authorized Official - Suffix:
Authorized Official - Credentials:MA AUDIOLOGIST
Authorized Official - Phone:323-791-3393
Mailing Address - Street 1:623 W DUARTE RD STE 8
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7349
Mailing Address - Country:US
Mailing Address - Phone:626-321-9944
Mailing Address - Fax:626-380-9262
Practice Address - Street 1:623 W DUARTE RD STE 8
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7349
Practice Address - Country:US
Practice Address - Phone:626-321-9944
Practice Address - Fax:626-380-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty