Provider Demographics
NPI:1578779161
Name:REGAN CLINICS,INC
Entity Type:Organization
Organization Name:REGAN CLINICS,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:REGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-473-0797
Mailing Address - Street 1:1516 W BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1817
Mailing Address - Country:US
Mailing Address - Phone:805-473-0797
Mailing Address - Fax:805-473-0804
Practice Address - Street 1:1516 W BRANCH ST
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-1817
Practice Address - Country:US
Practice Address - Phone:805-473-0797
Practice Address - Fax:805-473-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAUD247231H00000X
CAHA2323237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU00002471Medicaid
CAAU00002471Medicaid
CAAUD247AMedicare ID - Type Unspecified