Provider Demographics
NPI:1750771028
Name:MHC SOCAL LLC
Entity type:Organization
Organization Name:MHC SOCAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-849-8497
Mailing Address - Street 1:8941 S 700 E
Mailing Address - Street 2:204
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-2400
Mailing Address - Country:US
Mailing Address - Phone:801-849-8497
Mailing Address - Fax:801-200-3502
Practice Address - Street 1:8500 WILSHIRE BLVD
Practice Address - Street 2:103
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3121
Practice Address - Country:US
Practice Address - Phone:310-360-0332
Practice Address - Fax:310-360-6891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty