Provider Demographics
NPI:1578771325
Name:HEARING RESOURCE CENTER OF SAN MATEO, INC.
Entity Type:Organization
Organization Name:HEARING RESOURCE CENTER OF SAN MATEO, 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:650-579-4470
Mailing Address - Street 1:100 S ELLSWORTH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3939
Mailing Address - Country:US
Mailing Address - Phone:650-579-4470
Mailing Address - Fax:650-579-4471
Practice Address - Street 1:100 S ELLSWORTH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3939
Practice Address - Country:US
Practice Address - Phone:650-579-4470
Practice Address - Fax:650-579-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2330231H00000X
CAAU117231H00000X
CAAU372231H00000X
CAAU2409231H00000X
CAAU2242237600000X
CAHA7034237600000X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZ730814ZMedicare UPIN