Organization
BELTONE OF RIVERSIDE
Active
Other names
Beltone Hearing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MICHAEL BECERRIL ACA (PRESIDENT)
(951) 779-1237
Entity
Organization
Contact information
Practice address
5908 MAGNOLIA AVE, RIVERSIDE, CA 92506-1884
(951) 779-1237
(951) 779-1238
Mailing address
5908 MAGNOLIA AVE, RIVERSIDE, CA 92506-1884
(951) 779-1237
(951) 779-1238
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3537
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611A63223
BLUE CROSS OF CALIF.
CA
01
—
BEL-45460
SECUREHORIZONS PACIFICARE
CA
01
—
ZZZ64762Z
BLUESHIELD OF CALIF.
CA
Enumeration date
02/01/2007
Last updated
02/08/2011
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