Healthcare Provider Details

I. General information

NPI: 1508090168
Provider Name (Legal Business Name): ADVANCED HEARING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 E SUNSET RD STE F
LAS VEGAS NV
89120-4913
US

IV. Provider business mailing address

2360 MENDOCINO AVE # A2-106
SANTA ROSA CA
95403-3153
US

V. Phone/Fax

Practice location:
  • Phone: 702-873-1589
  • Fax:
Mailing address:
  • Phone: 707-291-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS153
License Number StateNV

VIII. Authorized Official

Name: MR. MIKE OWEN
Title or Position: PRESIDENT
Credential: AA
Phone: 707-291-2448