Provider Demographics
NPI:1467980136
Name:ENDERS, ALLEN FLOYD JR
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:FLOYD
Last Name:ENDERS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 N WANDA RD STE 135
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5344
Mailing Address - Country:US
Mailing Address - Phone:657-272-0426
Mailing Address - Fax:
Practice Address - Street 1:1467 N WANDA RD STE 135
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5344
Practice Address - Country:US
Practice Address - Phone:657-272-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA-8029237700000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81-5390601OtherHEARING AIDS