Provider Demographics
NPI:1821520511
Name:JOHN L FOLMAR
Entity Type:Organization
Organization Name:JOHN L FOLMAR
Other - Org Name:PENINSULA HEARING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLMAR
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:650-373-2081
Mailing Address - Street 1:533 AIRPORT BLVD
Mailing Address - Street 2:SU 400
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2018
Mailing Address - Country:US
Mailing Address - Phone:650-373-2081
Mailing Address - Fax:650-373-2002
Practice Address - Street 1:533 AIRPORT BLVD
Practice Address - Street 2:SU 400
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2018
Practice Address - Country:US
Practice Address - Phone:650-373-2081
Practice Address - Fax:650-373-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU-2029231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty