Provider Demographics
NPI:1659493013
Name:CSG-BETTER HEARING CENTER LLC
Entity Type:Organization
Organization Name:CSG-BETTER HEARING CENTER LLC
Other - Org Name:BETTER HEARING CENTER OF SAN LEANDRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-483-5422
Mailing Address - Street 1:410 ESTUDILLO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4908
Mailing Address - Country:US
Mailing Address - Phone:510-483-5422
Mailing Address - Fax:
Practice Address - Street 1:410 ESTUDILLO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4908
Practice Address - Country:US
Practice Address - Phone:510-483-5422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1138231H00000X
CAHA2506237600000X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0011380Medicaid
CAAU0011380OtherUNITED HEALTHCARE
CAHA0025060OtherBLUE SHIELD
CAAU0011380Medicaid