Provider Demographics
NPI:1881029395
Name:COLEMAN AND FALLON INC
Entity Type:Organization
Organization Name:COLEMAN AND FALLON INC
Other - Org Name:PARK PLACE HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/HEARING AID SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-763-3161
Mailing Address - Street 1:696 PETALUMA BLVD N
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2847
Mailing Address - Country:US
Mailing Address - Phone:707-763-3161
Mailing Address - Fax:707-763-9829
Practice Address - Street 1:696 PETALUMA BLVD N
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2847
Practice Address - Country:US
Practice Address - Phone:707-763-3161
Practice Address - Fax:707-763-9829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7468237700000X
332B00000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty