Healthcare Provider Details

I. General information

NPI: 1013185776
Provider Name (Legal Business Name): CLEAR TONE HEARING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 MESQUITE AVE. SUITE #5
LAKE HAVASU CITY AZ
86403
US

IV. Provider business mailing address

1930 MESQUITE AVE. SUITE #5
LAKE HAVASU CITY AZ
86403
US

V. Phone/Fax

Practice location:
  • Phone: 928-855-5252
  • Fax: 928-855-5283
Mailing address:
  • Phone: 928-855-5252
  • Fax: 928-855-5283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. JAHAN SHIRAVAND
Title or Position: OWNER/HEARING AID DISPENSER-SPECIAL
Credential: HAD5326
Phone: 928-855-5252