Provider Demographics
NPI:1043248040
Name:BURNEY DIGITAL HEARING CENTER
Entity type:Organization
Organization Name:BURNEY DIGITAL HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:760-323-8405
Mailing Address - Street 1:1005 N PALM CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4419
Mailing Address - Country:US
Mailing Address - Phone:760-323-8405
Mailing Address - Fax:760-323-8723
Practice Address - Street 1:1005 N PALM CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4419
Practice Address - Country:US
Practice Address - Phone:760-323-8405
Practice Address - Fax:760-323-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0002481Medicaid
CAAU0002481Medicaid