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General NPI Number Information
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NPI Number | 1306047808
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Entity Type | Organization
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Legal Business Name | SAMARITAN HEARING AID SPECIALIST
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2577 SAMARITAN DR STE 845
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City | SAN JOSE
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State | CA
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Zip | 95124-4110
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Country | US
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Telephone | 408-358-8507
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Fax | 408-358-8506
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Provider Business Mailing Address
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Address Line | 2577 SAMARITAN DR STE 845
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City | SAN JOSE
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State | CA
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Zip | 95124-4110
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Country | US
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Telephone | 408-358-8507
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Fax | 408-358-8506
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Authorized Official
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Title or Position | OWNER,CEO
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Name | AZAR DARYAEE SAJJADI
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Credential |
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Telephone | 408-358-8507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA4165
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License Number State | CA
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