Provider Demographics
NPI:1811318462
Name:WHITCOMB, CRAIG (HAD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:WHITCOMB
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 GARDEN GROVE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8234
Mailing Address - Country:US
Mailing Address - Phone:714-898-5732
Mailing Address - Fax:714-901-4058
Practice Address - Street 1:42410 BOB HOPE DR STE 1
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4468
Practice Address - Country:US
Practice Address - Phone:760-341-9619
Practice Address - Fax:760-341-9619
Is Sole Proprietor?:No
Enumeration Date:2013-12-29
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-272237700000X
CAHT9027237700000X
CAHA7942237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist