| Doctor Name: | GLEN ERIC FAIRFIELD |
| NPI Number: | 1639304173 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 2915 |
| Business Practice Address: | 160 N 9th St Grover Beach, CA - 934332122 |
| Business Phone Number: | 8054811523 |
| Business Fax Number: | 8054811269 |
| Mailing Address: | File #55745, LOS ANGELES |
| State: | CA |
| Postal Code: | 900745745 |
| Phone Number: | 5614788770 |
| Fax Number: | 5616888877 |
| NPI Enumeration Date: | 05/28/2009 |
| NPI Last Update Date: | 08/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | 2915 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |