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General NPI Number Information
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NPI Number | 1093091662
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Entity Type | Organization
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Legal Business Name | AMERICAN HEARING AID CENTER OF THE SOUTH BAY, INC
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 9340 CLAIREMONT MESA BLVD STE D
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City | SAN DIEGO
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State | CA
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Zip | 92123-1224
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Country | US
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Telephone | 858-278-9911
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Fax | 858-565-7324
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Provider Business Mailing Address
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Address Line | 13820 DONNYBROOK LN
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City | MOORPARK
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State | CA
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Zip | 93021-2827
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Country | US
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Telephone | 310-989-3092
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Fax | 805-530-3989
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Authorized Official
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Title or Position | OWNER
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Name | JOHN DANDURAND
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Credential | BC-HIS
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Telephone | 310-989-3092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | HA 2056
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License Number State | CA
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