Healthcare Provider Details

I. General information

NPI: 1477512382
Provider Name (Legal Business Name): HEAR SAN DIEGO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N ACACIA AVE STE 110
SOLANA BEACH CA
92075-1165
US

IV. Provider business mailing address

125 N ACACIA AVE STE 110
SOLANA BEACH CA
92075-1165
US

V. Phone/Fax

Practice location:
  • Phone: 619-475-7338
  • Fax:
Mailing address:
  • Phone: 619-475-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1983
License Number StateCA

VIII. Authorized Official

Name: DR. AMY BRYAN
Title or Position: CEO AND AUDIOLOGIST
Credential: AU.D.
Phone: 619-475-7338