Provider Demographics
NPI:1922349406
Name:CALIFORNIA HEARING AID CENTER WEST
Entity Type:Organization
Organization Name:CALIFORNIA HEARING AID CENTER WEST
Other - Org Name:CHAC WEST
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMPLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-721-0400
Mailing Address - Street 1:8041 GREENBACK LN
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-6909
Mailing Address - Country:US
Mailing Address - Phone:916-721-0400
Mailing Address - Fax:916-721-0434
Practice Address - Street 1:1580 WINCHESTER BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0519
Practice Address - Country:US
Practice Address - Phone:916-721-0400
Practice Address - Fax:916-721-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7514332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment